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干扰素α用于治疗感染人类免疫缺陷病毒的慢性丙型肝炎患者。肝炎 - 艾滋病西班牙研究小组。

Interferon alpha for the treatment of chronic hepatitis C in patients infected with human immunodeficiency virus. Hepatitis-HIV Spanish Study Group.

作者信息

Soriano V, García-Samaniego J, Bravo R, González J, Castro A, Castilla J, Martínez-Odriozola P, Colmenero M, Carballo E, Suárez D, Rodríguez-Piñero F J, Moreno A, del Romero J, Pedreira J, González-Lahoz J

机构信息

Centro de Investigación Clinica, Instituto de Salud Carlos III, Madrid, Spain.

出版信息

Clin Infect Dis. 1996 Sep;23(3):585-91. doi: 10.1093/clinids/23.3.585.

Abstract

Liver disease secondary to hepatitis C virus (HCV) infection is a rising cause of morbidity and mortality among individuals who have been infected parenterally with human immunodeficiency virus (HIV) such as injection drug users, hemophiliacs, and transfused patients. We analyzed both the efficacy of interferon (IFN) alpha therapy in these patients and the predictors of response to this agent. A total of 119 patients with chronic hepatitis C (90 of whom were infected with HIV and 29 of whom were not) were included in a multicenter, prospective, open, nonrandomized observational study. IFN-alpha was given subcutaneously in a dosage of 5 million units three times a week during a 3-month period; those patients who responded received a dose of 3 million units given subcutaneously three times a week for an additional 9 months. One hundred seven patients completed the study; the level of aminotransferases returned to normal and sera became negative (complete response) for HCV RNA in 26 (32.5%) of 80 HIV-infected patients and 10 (37.0%) of 27 non-HIV-infected patients (P = .666) after completion of the treatment. Two variables were independently associated with a response in HIV-infected patients: a CD4+ T lymphocyte count of > 500 x 10(6)/L and a baseline HCV viremia level of < 10(7) copies/mL. In the 12 months following treatment, relapses occurred in 30.8% of the HIV-infected patients and 12.5% of non-HIV-infected patients (P = .403).

摘要

丙型肝炎病毒(HCV)感染继发的肝病,在通过非肠道途径感染人类免疫缺陷病毒(HIV)的个体(如注射吸毒者、血友病患者和输血患者)中,正成为发病率和死亡率上升的一个原因。我们分析了干扰素(IFN)α疗法对这些患者的疗效以及对该药物反应的预测因素。一项多中心、前瞻性、开放性、非随机观察性研究纳入了总共119例慢性丙型肝炎患者(其中90例感染了HIV,29例未感染)。在3个月期间,IFN-α以每周3次、每次500万单位的剂量皮下注射;有反应的患者在接下来的9个月中,接受每周3次、每次300万单位的皮下注射剂量。107例患者完成了研究;治疗结束后,80例HIV感染患者中有26例(32.5%)、27例未感染HIV的患者中有10例(37.0%)的氨基转移酶水平恢复正常,血清HCV RNA变为阴性(完全反应)(P = 0.666)。两个变量与HIV感染患者的反应独立相关:CD4 + T淋巴细胞计数>500×10⁶/L以及基线HCV病毒血症水平<10⁷拷贝/mL。在治疗后的12个月中,HIV感染患者中有30.8%复发,未感染HIV的患者中有12.5%复发(P = 0.403)。

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