Watanabe Shinya, Kobayashi Yoshimasa, Kawata Kazuhito, Noritake Hidenao, Chida Takeshi, Nagasawa Masamichi, Kageyama Fujito, Kawamura Kinya, Sasada Yuzo, Suda Takafumi
Division of Hepatology, Department of Internal Medicine 2, Hamamatsu University School of Medicine, Japan.
Intern Med. 2015;54(3):273-9. doi: 10.2169/internalmedicine.54.2718.
Slow responders to pegylated interferon (Peg-IFN) and ribavirin (RBV) among patients infected with hepatitis C virus (HCV) genotype 1 may benefit from an extended treatment course. The aim of this study was to determine the efficacy of persistent negative serum HCV RNA over 96 weeks during long-term Peg-IFN monotherapy following 72 weeks of combination therapy.
A total of 46 HCV genotype 1-infected slow responders were treated for 72 weeks with Peg-IFN and RBV combination therapy alone (n=25) or additional long-term biweekly treatment with 90 μg of Peg-IFN-α2a (n=21). The criterion for the completion of long-term Peg-IFN monotherapy was defined as the attainment of constantly negative HCV RNA in the serum over 96 weeks during IFN treatment.
The patients with sustained negative serum HCV RNA during 96 weeks of IFN treatment had a higher rate of sustained virological response (SVR) than those without (81 vs. 40%, p=0.012). A multivariate analysis identified sustained negativity of serum HCV RNA over 96 weeks of IFN treatment to be a predictive factor for SVR.
In the present study, sustained negative serum HCV RNA over 96 weeks during long-term Peg-IFN monotherapy following 72 weeks of combination therapy of Peg-IFN and RBV resulted in beneficial virological outcomes among HCV genotype 1-infected slow responders.
丙型肝炎病毒(HCV)1型感染患者中,对聚乙二醇化干扰素(Peg-IFN)和利巴韦林(RBV)反应缓慢者可能从延长疗程中获益。本研究旨在确定在聚乙二醇化干扰素联合治疗72周后长期聚乙二醇化干扰素单药治疗期间96周内血清HCV RNA持续阴性的疗效。
共46例HCV 1型感染的反应缓慢者接受了单独聚乙二醇化干扰素和利巴韦林联合治疗72周(n = 25),或额外每两周接受90μg聚乙二醇化干扰素-α2a长期治疗(n = 21)。长期聚乙二醇化干扰素单药治疗完成的标准定义为在干扰素治疗期间96周内血清HCV RNA持续阴性。
在干扰素治疗96周期间血清HCV RNA持续阴性的患者持续病毒学应答(SVR)率高于未持续阴性的患者(81%对40%,p = 0.012)。多因素分析确定干扰素治疗96周内血清HCV RNA持续阴性是SVR的预测因素。
在本研究中,聚乙二醇化干扰素和利巴韦林联合治疗72周后长期聚乙二醇化干扰素单药治疗期间96周内血清HCV RNA持续阴性,在HCV 1型感染的反应缓慢者中产生了有益的病毒学结果。