干扰素α联合利巴韦林治疗丙型肝炎病毒与人类免疫缺陷病毒混合感染  

Interferon-αand ribavirin combination therapy for co-infection of hepatitis C virus and human immunodeficiency virus .

作　　者：郑煜煌[1] 何艳[1] 杨旭[1] 龚国忠[1] 周华英[1] 张春迎[1] 邹文[1] 黄力[1] 丁佩佩[1] 李慧[1] 

机构地区：[1]中南大学湘雅二医院传染科艾滋病研究室,长沙410011

出　　处：《中华肝脏病杂志》2005年第10期741-744,共4页Chinese Journal of Hepatology

摘　　要：目的观察干扰素α联合利巴韦林对中国人丙型肝炎病毒(HCV)与人类免疫缺陷病毒(HIV) 混合感染(HCV/HIV)患者的治疗效果及不良反应,并与其对单独HCV患者的治疗进行对比。方法10 例HCV/HIV患者和17例HCV患者,以肌肉注射干扰素α5 MU,隔日1次,口服利巴韦林0.3 g,3次/d, 动态观察两组的HCV RNA水平和HIV RNA水平,CD4+和CD8+T淋巴细胞计数,主要的肝功能和血细胞指标,以及主要的不良反应。结果HCV/HIV患者与HCV患者治疗12周和24周,HCV RNA较用药前平均分别下降1.14 log(t=3.843,P<0.01)和2.08 log(t=6.564,P<0.01),1.48 log(t=6.438,P <0.01)和2.33 log(t=7.343,P<0.01);同时HIV RNA也较用药前平均下降了1.22 log(t=3.662, P<0.01)和1.73 log(t=6.119,P<0.01),但两组用药前后的CD4+、CD8+T淋巴细胞计数变化不大, 27例患者的氨基转移酶除2例稍高以外其余均降至正常值。用药过程中部分病例发生流感样症状和消化道反应(多见于用药早期),白细胞总数和血红蛋白各有4例轻度下降;未发现明显精神神经异常和自身免疫疾病表现。结论以干扰素α联合利巴韦林治疗中国人HCV/HIV患者,用药24周的抗HCV效果不低于两种药物联合治疗单独HCV患者的效果,并有一定的抗HIV作用。两组的生化反应和不良反应差异无统计学意义。Objective To evaluate the clinical effect and side-effect of interferon- α（IFN- α） and ribavirin （RBV） combination therapy for Chinese patients with co-infection of hepatitis C virus （HCV） and human immunodeficiency virus （HIV）, and to compare them with only HIV infection patients. Methods 10 patients with HCV-HIV and 17 patients with only HCV infection received 5 million units of IFN α -2b every other day intramuscularly, and 300 mg RBV orally three times a day. Dynamic observations were done for HCV RNA and HIV RNA loads, CD4^＋ and CD8^＋ T lymphocyte counts, liver function and blood cell measures, and the side-effects of the medicines, Results After 12 weeks and 24 weeks oflFN α and RBV combination therapy, mean HCV RNA levels reduced 1.14 log （ t = 3.843, P 〈 0.01） and 2,08 log （t =6.564, P 〈 0.01） from the baseline at week 0 in the HCV-HIV co-infection group, and reduced 1.48 log （ t = 6.438, P 〈 0.01） and 2.33 log （ t = 7.343, P 〈 0.01） in the HCV infection group. Meanwhile, the HIV RNA levels decreased 1.22 log （ t = 3,662, P 〈 0.01） and 1,73 log （ t = 6.119, P 〈 0.01） from the base line, However, there were no obvious different changes among T lymphocyte counts of HCV-HIV and HCV patients at week 0, week 12 and week 24. All 27 patients showed satisfactory biochemical response to therapy. There were some mild or moderate influenza-like symptoms, intestinal discomfort and decreased blood cell counts in the early stages of the treatments. No neuropsychic and autoimmune disorders were found, Conclusions IFN α-2b and RBV combination therapy showed similar anti-HCV effects during the 24 week treatment for HCV-HIV and HCV infected patients, and some anti-HIV effect was also observed. No obvious different biochemical responses and side-effects were found between the above two groups.

关 键 词：干扰素Α 利巴韦林 肝炎病毒 丙型 人类免疫缺陷病毒 人类免疫缺陷病毒(HIV) 丙型肝炎病毒(HCV) 药物联合治疗 治疗效果 混合感染 T淋巴细胞计数 

分 类 号：R512.63[医药卫生—内科学] R512.91[医药卫生—临床医学]