Department of Gastroenterology, Adana Numune Training and Research Hospital, Adana, Turkey.
Eur J Gastroenterol Hepatol. 2013 Nov;25(11):1317-20. doi: 10.1097/MEG.0b013e328362797b.
It is unclear whether the magnitude of reduction in hepatitis C virus (HCV) RNA between baseline and week 4 of peginterferon-ribavirin treatment influences the probability of achieving a sustained virological response (SVR) in patients without a rapid virological response (RVR).
Data of 151 genotype 1 chronic hepatitis C patients treated with 48 weeks of peginterferon α-2a (group 1, n=86) and peginterferon α-2b (group 2, n=65), plus ribavirin, were evaluated retrospectively. Patients of each group were further divided into those who had RVR and those who did not. Patients without an RVR were then subdivided into four discrete categories on the basis of the magnitude of decrease in HCV RNA from baseline to week 4: those with a ≥3 log10 drop, those with a ≥2 log10 but <3 log10 drop, those with a ≥1 log10 but <2 log10 drop, and those with a <1 log10 drop. The proportion of SVR was calculated for each category.
Overall, 80 and 88.2% of RVR patients and 41.2 and 39.6% of non-RVR patients achieved an SVR in group 1 and group 2, respectively. Among non-RVR patients, the SVR rates were 75, 50, 16.7, and 11.1% in group 1 (trend test P=0.001) and 63.6, 42.9, 30, and 23.1% in group 2 (trend test P=0.038) in those with a drop in HCV RNA level of ≥3 log10, ≥2 log10, ≥1 log10, and <1 log10 at week 4, respectively.
Patients with a ≥3 log10 drop in HCV RNA at week 4 have a high probability of achieving an SVR when treated with either peginterferon α-2a-ribavirin or peginterferon α-2b-ribavirin.
基线至聚乙二醇干扰素-利巴韦林治疗第 4 周时 HCV RNA 下降幅度是否影响无快速病毒学应答（RVR）患者获得持续病毒学应答（SVR）的概率尚不清楚。
回顾性分析了 151 例基因型 1 慢性丙型肝炎患者的数据，他们接受了 48 周的聚乙二醇干扰素α-2a（1 组，n=86）和聚乙二醇干扰素α-2b（2 组，n=65）加利巴韦林治疗。每组患者进一步分为有 RVR 和无 RVR 的患者。无 RVR 的患者然后根据基线至第 4 周时 HCV RNA 下降幅度分为 4 个离散类别：下降≥3 log10，下降≥2 log10 但<3 log10，下降≥1 log10 但<2 log10，下降<1 log10。计算每个类别的 SVR 比例。
总体而言，RVR 患者的 SVR 率分别为 80%和 88.2%，无 RVR 患者的 SVR 率分别为 41.2%和 39.6%，在 1 组和 2 组中。在无 RVR 的患者中，1 组中 HCV RNA 水平下降≥3 log10、≥2 log10、≥1 log10 和<1 log10 的患者的 SVR 率分别为 75%、50%、16.7%和 11.1%（趋势检验 P=0.001），在 2 组中分别为 63.6%、42.9%、30%和 23.1%（趋势检验 P=0.038）。
在接受聚乙二醇干扰素α-2a-利巴韦林或聚乙二醇干扰素α-2b-利巴韦林治疗时，第 4 周时 HCV RNA 下降≥3 log10 的患者获得 SVR 的可能性较高。
