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聚乙二醇化干扰素α与利巴韦林治疗HIV-1/HCV合并感染患者的真实生活经验:持续病毒学应答的预测因素

Real life experience in treatment of HIV-1/HCV-coinfected patients with pegylated interferon alpha and ribavirin: predictors of SVR.

作者信息

Bruno Giuseppe, Fasano Massimo, Saracino Annalisa, Volpe Anna, Bartolomeo Nicola, Ladisa Nicoletta, Maggi Paolo, Monno Laura, Angarano Gioacchino

机构信息

Clinic of Infectious Diseases, University of Bari, Italy.

出版信息

New Microbiol. 2015 Jan;38(1):21-7. Epub 2015 Jan 1.

Abstract

Single nucleotide polymorphisms (SNPs) rs12979860 and rs8099917 near the interleukin 28B gene are predictors of virological response (SVR) to IFN-based therapy for monoinfected chronic hepatitis C patients. We retrospectively evaluated the impact of IL28B SNPs and other factors on SVR in a cohort of 102 HIV-1/HCV-coinfected patients treated with pegylated interferon-? (peg-INF?) and ribavirin. Data on baseline features and virological response at different time-points were collected. Overall, 89/102 patients (87%) were males, 44 (43%) of whom infected with HCV genotype 1; SVR was achieved by 50 patients (49%). A univariate logistic regression analysis demonstrated that rs129679860 SNP genotype CC (p<0.034), rs8099917 SNP genotype TT (p<0.01), HCV genotype 2 or 3 (p<0.0001), low HCV viral load (p<0.028) and RVR (rapid virological response) (p<0.0001) were associated with a higher likelihood of SVR. Multivariate analysis confirmed only RVR and HCV genotype as independent predictors of SVR. In a real life setting, the importance of RVR and IL28B SNPs was confirmed as predictive of SVR to identify patients with a higher likelihood of SVR to Peg-INF?+RBV, and also to designate a deferred therapy for patients with a low likelihood of SVR for whom it is preferable to wait for more successful options.

摘要

白细胞介素28B基因附近的单核苷酸多态性(SNP)rs12979860和rs8099917是单纯感染的慢性丙型肝炎患者接受基于干扰素治疗后病毒学应答(SVR)的预测指标。我们回顾性评估了白细胞介素28B单核苷酸多态性及其他因素对102例接受聚乙二醇化干扰素-α(peg-INF-α)和利巴韦林治疗的HIV-1/HCV合并感染患者SVR的影响。收集了不同时间点的基线特征和病毒学应答数据。总体而言,102例患者中有89例(87%)为男性,其中44例(43%)感染丙型肝炎病毒1型;50例患者(49%)实现了SVR。单因素逻辑回归分析表明,rs129679860 SNP基因型CC(p<0.034)、rs8099917 SNP基因型TT(p<0.01)、丙型肝炎病毒基因型2或3(p<0.0001)、低丙型肝炎病毒载量(p<0.028)和快速病毒学应答(RVR)(p<0.0001)与SVR可能性较高相关。多因素分析仅证实RVR和丙型肝炎病毒基因型是SVR的独立预测指标。在实际临床环境中,RVR和白细胞介素28B单核苷酸多态性作为SVR预测指标的重要性得到了证实,可用于识别接受聚乙二醇化干扰素-α+利巴韦林治疗时SVR可能性较高的患者,也可为SVR可能性较低且更适合等待更有效治疗方案的患者指定延迟治疗。

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