Dixit Vinod K, Ghosh Jayanta K, Lamtha Sangey C, Kaushik Pankaj, Goyal Sundeep K, Behera Manas K, Singh Neha, Jain Ashok K
Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh 221005, India.
J Clin Exp Hepatol. 2014 Jun;4(2):101-5. doi: 10.1016/j.jceh.2014.05.012. Epub 2014 Jun 18.
To assess the clinical profile of 80 chronic hepatitis C patients in a tertiary health care center in Northern India and also to study the efficacy and tolerability of pegylated interferon (Peg-IFN) α 2b and ribavirin therapy in a cohort of chronic hepatitis C patients.
Thirty subjects with chronic hepatitis C (CH-C) with genotypes 2 and 3 received Peg-IFN α 2b 1.5 μg/kg subcutaneously weekly plus daily ribavirin 800 mg for 24 weeks .Subjects with genotype 1 infection received therapy for 48 weeks with ribavirin 1000 mg/day and Peg-IFN α 2b dose remained the same. The primary end point was the sustained viral response (SVR). Drug dosage was modified or temporarily discontinued if anemia or bone marrow suppression developed.
The clinical profile of chronic hepatitis C infected patients showed decompensated cirrhosis in the more elderly patients. Genotype 3 was the commonest genotype and was seen in 21 (70%) patients. The mean baseline HCV RNA was high. SVR was achieved less commonly with genotype 1 than with genotype 2/3. Patients who became negative for HCV RNA at 4-weeks (rapid virological response or RVR) and 12 weeks (early virological response or EVR) of treatment showed significantly higher sustained virological response (SVR) rates. Similarly, patients who showed normalization of ALT level at 4-weeks and 12-weeks of treatment showed significant high rate of SVR. Overall treatment was well tolerated.
In our region, CHC subjects have high viral load and genotype 3 being the most common. Treatment with Peg-IFN α 2b and ribavirin is effective and well tolerated. Genotype 1 was more resistant to the treatment. Patients who achieved RVR and EVR are more likely to achieve SVR. Although the numbers of patients in this study was small, considering the paucity of data of treatment from India, the data is relevant.
评估印度北部一家三级医疗保健中心80例慢性丙型肝炎患者的临床特征，并研究聚乙二醇化干扰素（Peg-IFN）α 2b与利巴韦林联合治疗慢性丙型肝炎患者的疗效和耐受性。
30例基因2型和3型慢性丙型肝炎（CH-C）患者接受皮下注射Peg-IFN α 2b 1.5 μg/kg，每周1次，加用利巴韦林每日800 mg，疗程24周。基因1型感染患者接受利巴韦林1000 mg/天治疗48周，Peg-IFN α 2b剂量不变。主要终点为持续病毒学应答（SVR）。若出现贫血或骨髓抑制，则调整药物剂量或暂时停药。
慢性丙型肝炎感染患者的临床特征显示，老年患者中失代偿期肝硬化更为常见。基因3型是最常见的基因型，21例（70%）患者为此基因型。平均基线丙型肝炎病毒核糖核酸（HCV RNA）水平较高。基因1型患者达到SVR的情况比基因2/3型患者少见。治疗4周（快速病毒学应答或RVR）和12周（早期病毒学应答或EVR）时HCV RNA转为阴性的患者，持续病毒学应答（SVR）率显著更高。同样，治疗4周和12周时丙氨酸氨基转移酶（ALT）水平恢复正常的患者，SVR率也显著更高。总体而言治疗耐受性良好。
在我们地区，慢性丙型肝炎患者病毒载量高，基因3型最为常见。Peg-IFN α 2b与利巴韦林联合治疗有效且耐受性良好。基因1型对治疗更具抗性。达到RVR和EVR的患者更有可能实现SVR。尽管本研究中的患者数量较少，但考虑到印度治疗数据匮乏，这些数据仍具有参考价值。
