National Institute for Lasers and Optronics, Pakistan Atomic Energy Commission, Islamabad, Pakistan.
Intervirology. 2017;60(3):75-81. doi: 10.1159/000481913. Epub 2017 Nov 16.
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.
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.
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.
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.
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。
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。
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。
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。