Oh In Soo, Won Joung Won, Kim Hyung Joon, Lee Hyun Woong
Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
Korean J Intern Med. 2017 Nov;32(6):1010-1017. doi: 10.3904/kjim.2016.405. Epub 2017 Aug 11.
BACKGROUND/AIMS: Combined treatment of pegylated interferon-α (PEG-IFN) and ribavirin (RBV) has long been accepted as the standard treatment for chronic hepatitis C virus (HCV) infection. Many predictive factors for treatment response have been identified. The aim of this study was to evaluate the efficacy and safety of combined PEG-IFN plus RBV and to examine the value of serum uric acid as a predictive factor in the treatment of chronic hepatitis C.
A total of 74 patients chronically infected with HCV were enrolled between December 2004 and June 2009. Patients received subcutaneous PEG-IFN (α-2a: 180 μg once a week) in combination with RBV (1,000 to 1,200 mg daily depending on body weight). We evaluated treatment responses represented by early virologic response (EVR), end-of-treatment response (ETR), sustained virologic response (SVR), and relapse, as well as diverse adverse events. Various viral and host features were also assessed to clarify factors associated with treatment response.
During treatment, EVR was achieved in 26 patients (26/33, 78.8%) with HCV genotype 1. ETR and SVR were achieved in 59 (77.6%) and 56 patients (73.6%), respectively, across all genotypes. Genotype 2/3, lower HCV RNA, and lower uric acid were associated with higher SVR.
The treatment response to combination therapy with PEG-IFN plus RBV was effective, especially in genotype 2/3. Uric acid might be useful as a predictive factor for response to therapy for chronic hepatitis.
背景/目的：聚乙二醇化干扰素-α（PEG-IFN）联合利巴韦林（RBV）治疗长期以来一直被公认为慢性丙型肝炎病毒（HCV）感染的标准治疗方法。已经确定了许多治疗反应的预测因素。本研究的目的是评估PEG-IFN联合RBV治疗的疗效和安全性，并探讨血清尿酸作为慢性丙型肝炎治疗预测因素的价值。
2004年12月至2009年6月期间共纳入74例慢性HCV感染患者。患者接受皮下注射PEG-IFN（α-2a：每周1次，180μg）联合RBV（根据体重每日1000至1200mg）治疗。我们评估了以早期病毒学应答（EVR）、治疗结束时应答（ETR）、持续病毒学应答（SVR）和复发为代表的治疗反应，以及各种不良事件。还评估了各种病毒和宿主特征，以阐明与治疗反应相关的因素。
治疗期间，26例HCV基因1型患者（26/33，78.8%）实现了EVR。所有基因型患者中，分别有59例（77.6%）和56例（73.6%）实现了ETR和SVR。基因2/3型、较低的HCV RNA水平和较低的尿酸水平与较高的SVR相关。
PEG-IFN联合RBV的联合治疗反应有效，尤其是在基因2/3型患者中。尿酸可能作为慢性丙型肝炎治疗反应的预测因素。
