Miyauchi Tomoo, Kanda Tatsuo, Imazeki Fumio, Mikata Rintaro, Tawada Akinobu, Arai Makoto, Fujiwara Keiichi, Nakamoto Shingo, Wu Shuang, Tanaka Takeshi, Miyamura Tatsuo, Kimura Michio, Hirai Yasuo, Takashi Motohide, Mikami Shigeru, Sugiura Nobuyuki, Natsuki Yutaka, Azemoto Ryosaku, Suzuki Noriaki, Yokosuka Osamu
Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
Social Insurance Funabashi Chuo Hospital, Funabashi, 273-8566, Japan.
Hepatol Int. 2013 Mar;7(1):144-52. doi: 10.1007/s12072-012-9349-4. Epub 2012 Feb 10.
Patient age and gender may be associated with response to peginterferon alpha plus ribavirin, the current standard of care (SOC) for chronic hepatitis C genotype 1. We queried whether there was an association between age, gender, and treatment response to SOC in Japanese patients infected with hepatitis C virus (HCV) genotype 1.
Between 2006 and 2009, HCV-infected Japanese patients treated with peginterferon alpha-2b plus ribavirin for 48 weeks were enrolled. Patients were allocated into four groups according to age and gender, and epidemiological data and treatment outcomes were retrospectively analyzed. HCV RNA was measured with COBAS AMPLICOR HCV Monitor Test v. 2.0.
The overall sustained virological response (SVR) rate was 49.8%: patients aged ≤65 and >65 years, 50.9 and 44.0%, respectively; male and female, 56.5 and 39.0%. SVR rates of SOC against HCV genotype-1 females aged >65 years (19.0%) were inferior to those in males aged >65 years (57.8%) in Japan. Multivariate logistic regression analysis showed that SVR was attained independently of adherence 80/80/80 in all groups.
Adherence to medication is also a key factor for the eradication of HCV in patients aged >65 years. As the SVR rate of patients aged ≤65 years was similar to that of patients aged >65 years, SOC could be useful for treating some of the elderly patients.
患者年龄和性别可能与聚乙二醇干扰素α联合利巴韦林（目前治疗慢性丙型肝炎基因1型的标准疗法）的疗效相关。我们探究了在感染丙型肝炎病毒（HCV）基因1型的日本患者中，年龄、性别与标准疗法治疗反应之间是否存在关联。
纳入2006年至2009年间接受聚乙二醇干扰素α-2b联合利巴韦林治疗48周的HCV感染日本患者。根据年龄和性别将患者分为四组，对流行病学数据和治疗结果进行回顾性分析。采用COBAS AMPLICOR HCV Monitor Test v. 2.0检测HCV RNA。
总体持续病毒学应答（SVR）率为49.8%：年龄≤65岁和＞65岁的患者分别为50.9%和44.0%；男性和女性分别为56.5%和39.0%。在日本，标准疗法对年龄＞65岁的HCV基因1型女性的SVR率（19.0%）低于年龄＞65岁的男性（57.8%）。多因素逻辑回归分析显示，所有组中SVR的实现均与80/80/80依从性无关。
坚持用药也是＞65岁患者根除HCV的关键因素。由于≤65岁患者的SVR率与＞65岁患者相似，标准疗法可能对部分老年患者有用。
