聚乙二醇化干扰素α-2a与聚乙二醇化干扰素α-2b对伊朗慢性丙型肝炎患者的疗效及耐受性
Efficacy and Tolerability of Peginterferon alpha-2a and Peginterferon alpha-2b in Iranian Patients With Chronic Hepatitis C.
作者信息
Pouresmaeeli Mahdiyar, Alavian Seyed Moayed, Keshvari Maryam, Salimi Shima, Mehrnoush Leila
机构信息
Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Tehran, IR Iran ; Middle East Liver Diseases Center (MELD), Tehran, IR Iran.
Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, IR Iran.
出版信息
Hepat Mon. 2015 Sep 29;15(9):e30780. doi: 10.5812/hepatmon.30780. eCollection 2015 Sep.
BACKGROUND
Nearly 0.5% of Iranians are infected with HCV. Peginterferon-alpha-2a and Peginterferon-alpha-2b are the two available types of interferon for the treatment of hepatitis C. Comparing the results of these two treatments is still a challenge.
OBJECTIVES
The aim of this study was to compare the results of Peginterferon-alpha-2a and Peginterferon-alpha-2b in Iranian patients with chronic hepatitis C.
PATIENTS AND METHODS
289 patients with chronic hepatitis C attending Tehran Hepatitis Center (THC) and Hepatitis Clinic of Tehran Blood Transfusion Organization (TBTO) from January 2008 to April 2013 and treated with combination of Peginterferon-alpha-2a or Peginterferon-alpha-2b plus Ribavirin were enrolled in this retrospective cross-sectional study. Treatment response and side effects were compared.
RESULTS
Among all naive patients, 82.0% achieved SVR, 5.4% were resistant to therapy and 11.0% withdrew the treatment. Relapse was seen in 12.2% of naive patients who finished the course of treatment. RVR and EVR were seen in 67.7% and 90.6% of naive patients, respectively. Patients divided into two groups. Group A consists of 247 patients treated with Peginterferon-alpha-2a and group B 42 patients treated with Peginterferon-alpha-2b. No significant difference in treatment response was observed between naive patients of the two groups. The rates of arthralgia/myalgia, alopecia, pruritus, insomnia, dyspnea and anorexia were higher in group A and the rates of dermal problems, coryza and bleeding were higher in group B. In a subgroup analysis, the two kinds of Peginterferon-alpha-2a available in Iran were compared. Rapid and early viral responses and relapse rates were lower in the one made in Iran and the long-term responses were not different. The rates of arthralgia/myalgia, fever, alopecia, pruritus, insomnia, dyspnea, anorexia, cough, headache and abdominal pain were higher and the rates of irritability and coryza were lower in the one made in Iran.
CONCLUSIONS
There was no significant difference in the efficacy of Peginterferon-alpha-2a and Peginterferon-alpha-2b in Iranian patients. Physicians might choose the treatment regimen for every individual concerning the differences in side effects of Peginterferons.
背景
近0.5%的伊朗人感染了丙型肝炎病毒。聚乙二醇化干扰素α-2a和聚乙二醇化干扰素α-2b是两种可用于治疗丙型肝炎的干扰素。比较这两种治疗方法的结果仍然是一项挑战。
目的
本研究旨在比较聚乙二醇化干扰素α-2a和聚乙二醇化干扰素α-2b在伊朗慢性丙型肝炎患者中的治疗结果。
患者与方法
本回顾性横断面研究纳入了2008年1月至2013年4月期间在德黑兰肝炎中心（THC）和德黑兰输血组织肝炎诊所（TBTO）就诊并接受聚乙二醇化干扰素α-2a或聚乙二醇化干扰素α-2b联合利巴韦林治疗的289例慢性丙型肝炎患者。比较了治疗反应和副作用。
结果
在所有初治患者中，82.0%实现了持续病毒学应答，5.4%对治疗耐药，11.0%退出治疗。完成治疗疗程的初治患者中有12.2%出现复发。初治患者中快速病毒学应答和早期病毒学应答的发生率分别为67.7%和90.6%。患者分为两组。A组由247例接受聚乙二醇化干扰素α-2a治疗的患者组成，B组由42例接受聚乙二醇化干扰素α-2b治疗的患者组成。两组初治患者的治疗反应无显著差异。A组关节痛/肌痛、脱发、瘙痒、失眠、呼吸困难和厌食的发生率较高，B组皮肤问题、鼻炎和出血的发生率较高。在亚组分析中，比较了伊朗可用的两种聚乙二醇化干扰素α-2a。伊朗生产的那种聚乙二醇化干扰素α-2a的快速和早期病毒学应答以及复发率较低，长期应答无差异。伊朗生产的那种聚乙二醇化干扰素α-2a的关节痛/肌痛、发热、脱发、瘙痒、失眠、呼吸困难、厌食、咳嗽、头痛和腹痛的发生率较高，易怒和鼻炎的发生率较低。
结论
聚乙二醇化干扰素α-2a和聚乙二醇化干扰素α-2b在伊朗患者中的疗效无显著差异。医生可根据聚乙二醇化干扰素副作用的差异为每个患者选择治疗方案。
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