HIV患者合并感染基因1和4型丙型肝炎病毒治疗效果的Meta分析  

Meta-analysis on peginterferon plus ribavirin in treatment of hepatitis C virus genotype 1 or 4 infection in HIV patients

作　　者：赵四海[1,2] 刘恩岐[2] 成大欣[3] 薛欣[1] 楚雍烈[1] 

机构地区：[1]西安交通大学医学院病原生物学与免疫学系,陕西西安710061 [2]西安交通大学医学院医学实验动物中心,陕西西安710061 [3]西安交通大学医学院第三附属医院新生儿科,陕西西安710061

出　　处：《浙江大学学报（医学版）》2009年第3期315-319,共5页Journal of Zhejiang University(Medical Sciences)

基　　金：国家自然科学基金资助项目(30470089)

摘　　要：目的:探讨HIV患者共感染难治性丙型肝炎病毒(HCV,基因1型和4型)后的临床药物处理对策。方法:收集国内外2000年至今报道的干扰素或聚乙二醇干扰素联合利巴韦林治疗HCV/HIV共感染患者的随机临床对照试验结果,提取其中共感染基因1型或4型HCV的HIV患者资料。利用Meta分析方法探讨HIV患者罹患丙型肝炎后,尤其是感染基因1型或4型HCV后的治疗方案。结果:Medline文献检索结果命中88篇文献,其中6篇符合纳入标准,共提取感染基因1型或4型HCV的HIV患者资料1 131份。数据分析结果显示,聚乙二醇干扰素联合利巴韦林治疗基因1型或4型HCV的HIV患者所获得的持续病毒反应率是26%,高于干扰素联合利巴韦林治疗的反应率(8%)。聚乙二醇干扰素联合利巴韦林治疗也优于聚乙二醇干扰素单独疗法(26%vs 13%)。而聚乙二醇干扰素联合利巴韦林疗法在基因2型或3型HCV感染的HIV患者可获得55%的持续病毒反应率。干扰素或聚乙二醇干扰素联合利巴韦林治疗HCV/HIV共感染患者的副反应发生率和停药率相似。结论:聚乙二醇干扰素联合利巴韦林在治疗基因1型或4型HCV的HIV患者时优于干扰素联合利巴韦林或聚乙二醇干扰素单独疗法。Objective： To perform a Meta-analysis on peginterferon with interferon in treatment of HIV patients coinfected with refractory genetype HCV. Methods： A literature search of Medline was conducted to identify eligible randomized controlled trials. Meta analysis was conducted to evaluate peginterferon and interferon in treatment of coinfected HCV genotype 1 or 4 in HIV patients. Results： Six trials of 88 matched the selection criteria. Total 1 131 patients with coinfection of HCV genotype 1 or 4 and HIV were included. Sustain viral response was higher in patients treated with peginterferon plus ribavirin compared with that of interferon plus ribavirin （26% vs 8%） or peginterferon alone （26% vs 13%）. Severe adverse effects and withdrawal rates were similar for patients treated with peginterferon and patients treated with interferon. Conclusion： Peginterferon plus ribavirin in treatment of patients with coinfection of genotype 1 or 4 HCV and HIV can achieve higher sustain viral response and the likelihoods of serious adverse effects and withdrawal rates are similar to other therapies.

关 键 词：肝炎病毒 基因型 重叠感染/免疫学 干扰素-α2a/治疗应用 聚乙烯二醇类/治疗应用 利巴韦林/治疗应用 药物疗法 联合 

分 类 号：R512.91[医药卫生—内科学] R512.6[医药卫生—临床医学]