摘要
目的:评价聚乙二醇干扰素(peginterferon,pegIFN)联合利巴韦林治疗经治慢性丙型肝炎(chronic hepatitis C,CHC)患者的病毒学应答及安全性.方法:根据CHC患者经治方案的不同分组,分析再次以pegIFN联合利巴韦林治疗后的病毒学应答:快速病毒学应答(rapid virologic response,RVR)、早期病毒学应答(early virologic response,EVR)、治疗结束时病毒学应答(end-of-treatment virologic response,ETR)、持续病毒学应答(sustained virologic response,SVR)、复发率及中止治疗比率,并分析影响临床结局的影响因素.结果:(1)既往采用pegIFN联合利巴韦林治疗的经治患者,再次以该方案治疗后获得RVR、EVR、ETR、SVR的比率相对偏低(分别为21.1%vs40.5%,26.3%vs43.2%,47.4%vs56.8%,31.6%vs46.0%),与IFN组比较无统计学差异(P>0.05);(2)既往以pegIFN联合利巴韦林治疗的经治患者,再次以该方案治疗后的复发率相对较高,但与IFN组比较无统计学差异(33.3%vs19.0%,P>0.05);(3)经治CHC患者获得ETR可能为其获得SVR的有利因素(OR=20.43,P=0.004).结论:对经治CHC患者再次采用pegIFN联合利巴韦林抗病毒仍可取得相对有效的病毒学应答,既往以pegIFN联合利巴韦林抗病毒的经治CHC患者,不支持继续以相同方案抗病毒,获得ETR可能为该部分患者获得SVR的有利因素.
AIM： To evaluate the virologic responses and safety of peginterferon plus ribavirin therapy for treatment of chronic hepatitis C （CHC） in patients who had undergone previous antiviral therapy.METHODS： All patients were divided into two groups based on the type of previously used in- terferon. Virologic responses, including rapid vi-rologic response （RVR）, early virologic response （EVR）, end-of-treatment virologic response （ETR） and sustained virologic response （SVR）, relapse rate and discontinuation rate were assessed after retreatment with peginterferon plus ribavirin. RESULTS： For CHC patients previously treated with peginterferon plus ribavirin, retreatment by the same regimen might be associated with lower RVR, EVR, ETR and SVR rates （21.1% vs 40.5%, 26.3% vs 43.2%, 47.4% vs 56.8%, 31.6% vs 46.0%） and a higher relapse rate （33.3% vs 19.0%）, but no significance was found compared with those treated with standard interferon （all P 〉 0.05）. Achieving EVR might be a positive factor for achieving SVR in patients previously treated with interferons （IFNs） （OR = 20.43, P=0.004）. CONCLUSION： Peginterferon plus ribavirin therapy is effective for CHC patients previously treated with IFNs; however, retreatment with the same regimen for CHC patients previously treated with peginterferon plus ribavirin is not recommended. Achieving EVR might be a posi- tive factor for achieving SVR in patients previ- ously treated with IFNs.
出处
《世界华人消化杂志》
CAS
北大核心
2013年第19期1797-1802,共6页
World Chinese Journal of Digestology
基金
国家十二五科技重大专项基金资助项目
No.2012ZX10004301004~~
