Negro F, Male P J, Perrin L, Giostra E, Hadengue A
Division of Gastroenterology and Hepatology, University Hospital, Geneva, Switzerland.
J Hepatol. 1998 Sep;29(3):369-74. doi: 10.1016/s0168-8278(98)80053-6.
BACKGROUND/AIMS: Ofloxacin, a quinolone antibiotic, was recently shown to increase the primary response rate to alpha-interferon treatment of chronic hepatitis C.
Fifty-five patients with chronic hepatitis C were scheduled to receive 3 MU of a-interferon, three times a week, for 1 year. After 3 months of therapy, patients who were still HCV RNA-positive in serum started receiving a combined regimen with 3 MU of alpha-interferon, three times a week, plus ofloxacin, 600 mg daily, per os. After 3 months of combined therapy, patients with undetectable serum HCV RNA continued the combined regimen for another 6 months, whereas patients who were still HCV RNA-positive were definitively considered as non-responders and withdrawn from the study. Serum HCV RNA levels were quantitatively evaluated after 3 months of therapy with a-interferon alone and compared with those detected after 3 months of combined regimen.
Among the 54 patients who completed the first 3 months of treatment, 32 (59.3%) still had HCV RNA detectable in serum and started receiving the ofloxacin/alpha-interferon therapy. Among the 26 patients who completed the 3 additional months of combined regimen, only one showed a virological response: this patient maintained a complete response to the end of combined treatment, but relapsed thereafter. The combination therapy had no effect on the serum HCV RNA or alanine aminotransferase levels.
The combined administration of alpha-interferon and ofloxacin to patients with chronic hepatitis C who have not responded to alpha-interferon alone does not increase the primary virological response rate.
背景/目的:喹诺酮类抗生素氧氟沙星最近被证明可提高慢性丙型肝炎患者对α干扰素治疗的初始反应率。
55例慢性丙型肝炎患者计划接受3MUα干扰素治疗,每周3次,共1年。治疗3个月后,血清中HCV RNA仍为阳性的患者开始接受联合治疗方案,即3MUα干扰素,每周3次,加氧氟沙星,每日600mg,口服。联合治疗3个月后,血清HCV RNA检测不到的患者继续联合治疗方案6个月,而血清HCV RNA仍为阳性的患者被明确视为无反应者并退出研究。在单独使用α干扰素治疗3个月后定量评估血清HCV RNA水平,并与联合治疗方案3个月后检测到的水平进行比较。
在完成前3个月治疗的54例患者中,32例(59.3%)血清中仍可检测到HCV RNA,并开始接受氧氟沙星/α干扰素治疗。在完成额外3个月联合治疗方案的26例患者中,只有1例出现病毒学反应:该患者在联合治疗结束时维持完全反应,但此后复发。联合治疗对血清HCV RNA或丙氨酸氨基转移酶水平无影响。
对单独使用α干扰素无反应的慢性丙型肝炎患者联合使用α干扰素和氧氟沙星不会提高初始病毒学反应率。