丙型肝炎基因型 2 感染患者治疗应答的病毒学预测因子。
Virological predictors of response to retreatment in hepatitis C genotype 2 infected patients.
机构信息
Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
出版信息
PLoS One. 2013;8(3):e58882. doi: 10.1371/journal.pone.0058882. Epub 2013 Mar 19.
BACKGROUND/AIMS: The impact of virological factors and interleukin-28B (IL-28B) genetic variants on retreatment of hepatitis C virus genotype 2 (HCV-2) treatment-experienced patients remains unknown.
METHODS
On-treatment virological responses and IL-28B rs8099917 genotype were determined in 46 HCV-2 treatment-experienced patients (42 previous relapsers; four previous non-responders) retreated with 24-week peginterferon/ribavirin.
RESULTS
Forty (87.0%) patients carried the rs8099917 TT genotype and 6 patients (13.0%) carried the TG/GG genotype. The sustained virological response (SVR; seronegativity of HCV RNA throughout 24 weeks of the post-treatment follow-up period) rate was 71.7%. Compared with previous non-responders, previous relapsers had a significantly higher SVR rate (78.6% vs. 0%, P = 0.004) and a lower relapse rate (17.5% vs. 100%, P = 0.04). All the previous non-responders were with the rs8099917 TT genotype. As for those who relapsed, treatment responses, including the rates of rapid virological response (RVR, 80.6% vs. 66.7%, P = 0.59), early virological response (EVR, 97.2% vs. 83.3%, P = 0.27), end-of-treatment virological response (97.2% vs. 83.3%, P = 0.27) and SVR (80.6% vs. 66.7%, P = 0.59) and relapse rate (17.1% vs. 20.0%, P = 1) did not differ significantly between patients with the rs8099917 TT and those with the non-TT genotype. Multivariate analysis revealed that the most important factor predictive of an SVR in the retreatment of HCV-2 was previous relapse; the only factor predictive of an SVR for previous relapsers was the achievement of an EVR. Compared with the achievement of a RVR, the attainment of an EVR was more accurate in predicting an SVR (88% vs. 74%).
CONCLUSIONS
Peginterferon/ribavirin is effective in the retreatment of HCV-2 relapsers, especially among those who achieved an EVR.
背景/目的：病毒学因素和白细胞介素 28B（IL-28B）遗传变异对丙型肝炎病毒基因型 2（HCV-2）治疗后复发患者的再治疗的影响尚不清楚。
方法
对 46 例 HCV-2 治疗后复发的患者（42 例既往复发；4 例既往无应答）进行了治疗中病毒学应答和 IL-28B rs8099917 基因型的检测，这些患者接受了 24 周的聚乙二醇干扰素/利巴韦林治疗。
结果
40 例（87.0%）患者携带 rs8099917 TT 基因型，6 例（13.0%）患者携带 TG/GG 基因型。持续病毒学应答（SVR；治疗后随访 24 周期间 HCV RNA 血清学阴性）率为 71.7%。与既往无应答者相比，既往复发者的 SVR 率显著更高（78.6% vs. 0%，P=0.004），复发率更低（17.5% vs. 100%，P=0.04）。所有既往无应答者均为 rs8099917 TT 基因型。对于那些复发的患者，治疗反应，包括快速病毒学应答（RVR，80.6% vs. 66.7%，P=0.59）、早期病毒学应答（EVR，97.2% vs. 83.3%，P=0.27）、治疗结束时病毒学应答（97.2% vs. 83.3%，P=0.27）和 SVR（80.6% vs. 66.7%，P=0.59）以及复发率（17.1% vs. 20.0%，P=1）在 rs8099917 TT 基因型和非 TT 基因型患者之间无显著差异。多因素分析显示，在 HCV-2 的再治疗中，预测 SVR 的最重要因素是既往复发；对既往复发者预测 SVR 的唯一因素是 EVR 的获得。与 RVR 的获得相比，EVR 的获得在预测 SVR 方面更准确（88% vs. 74%）。
结论
聚乙二醇干扰素/利巴韦林对 HCV-2 复发患者的再治疗有效，特别是对那些获得 EVR 的患者。
Zotero 插件