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评价聚乙二醇干扰素-α-2b 联合利巴韦林治疗基因 3a 型丙型肝炎病毒感染患者的时间病毒学应答。

Evaluation of Temporal Virological Responses to Interferon-α-2b plus Ribavirin among Genotype 3a Hepatitis C Virus-Infected Patients.

机构信息

National Institute for Lasers and Optronics, Pakistan Atomic Energy Commission, Islamabad, Pakistan.

出版信息

Intervirology. 2017;60(3):75-81. doi: 10.1159/000481913. Epub 2017 Nov 16.

Abstract

OBJECTIVES

The present study aimed to examine the impact of rapid virological response (RVR) and early virological response (EVR) on sustained virological response (SVR) in chronic hepatitis C genotype 3a individuals.

METHODS

The patients were given antiviral therapy with IFN-α-2b, 3 million units 3 times a week and 800-1,200 mg of ribavirin daily adjusted to the patient's body weight (<60 kg 800 mg day-1, and >60 kg 1,200 day-1). The patients received this combination therapy for 24 weeks. The patients were evaluated for their viral load at week 4, 12, and 24 using RT-PCR.

RESULTS

Out of 1,471 patients, 43.3% showed a negative viral load in week 4, demonstrating RVR, whereas 56.6% maintained a high viral load. These were further separated based on viral reduction in their plasma: either negative for HCV-RNA at week 12 (n = 575), manifesting EVR, or showing a 2-log reduction in HCV viral load classified as partial EVR (PEVR; n = 259). The PEVR response was less (29.7%) compared with RVR (85.9%) and EVR (69.0%), although nonresponders were found in both groups.

CONCLUSIONS

Individuals incompliant with their treatment who have a higher RVR significantly influence their SVR towards a better remission that can be treated within a short duration with standard treatment.

摘要

目的

本研究旨在探讨慢性丙型肝炎基因型 3a 个体的快速病毒学应答(RVR)和早期病毒学应答(EVR)对持续病毒学应答(SVR)的影响。

方法

给予干扰素-α-2b 抗病毒治疗,每周 3 次,每次 300 万单位,利巴韦林每日 800-1200mg,根据患者体重调整(<60kg 为 800mg/天,>60kg 为 1200mg/天)。患者接受这种联合治疗 24 周。采用 RT-PCR 法在第 4、12 和 24 周评估患者的病毒载量。

结果

在 1471 例患者中,43.3%在第 4 周出现病毒载量阴性,表现为 RVR,而 56.6%维持高病毒载量。根据血浆中病毒的减少进一步将其分开:第 12 周 HCV-RNA 阴性(n=575),表现为 EVR,或 HCV 病毒载量降低 2 个对数级,分类为部分 EVR(PEVR;n=259)。PEVR 反应率(29.7%)低于 RVR(85.9%)和 EVR(69.0%),尽管两组均存在无应答者。

结论

治疗不依从且 RVR 较高的个体对 SVR 有显著影响,可使他们获得更好的缓解,而采用标准治疗在短期内即可实现这种缓解。

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