聚乙二醇干扰素α-2a联合利巴韦林治疗慢性丙型肝炎患者的病毒学应答  

Virological response of chronic hepatitis C treated with peg-interferon α-2a and Ribavirin

作　　者：姜雪强[1] 邹小静[1] 田德英[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院感染科,武汉430000

出　　处：《临床肝胆病杂志》2011年第4期417-419,共3页Journal of Clinical Hepatology

基　　金：湖北省自然科学基金重大项目(2008CDA049)

摘　　要：目的观察聚乙二醇干扰素α-2a(PEG-IFNα-2a)联合利巴韦林治疗慢性丙型肝炎(CHC)的疗效。方法回顾性分析在本院门诊接受抗病毒治疗的58例CHC患者,其中HCV-1型患者43例,HCV-2型患者15例,均给予PEG-IFNα-2a和利巴韦林治疗,疗程48周。分别在治疗前、治疗后4、12、24周,治疗终点,治疗结束后24周及48周测定患者血浆HCV RNA水平。结果 HCV-2型患者4周快速病毒学应答(RVR)率明显高于HCV-1型患者(80%vs 48.8%,P<0.05);治疗结束后随访48周HCV-2型患者的持续病毒应答(SVR)率明显高于1型患者(86.7%vs 53.5%,P<0.05)。低病毒载量患者(RNA<2×106拷贝/ml)的RVR率明显高于高病毒载量患者(93.8%vs 46.2%,P<0.05);治疗结束后随访48周低病毒载量患者的SVR率明显高于高病毒载量者(84.2%vs 51.3%,P<0.05)。结论 PEG-IFNα-2a联合利巴韦林治疗CHC安全有效,对基因2型疗效优于基因1型,病毒载量低的患者疗效优于病毒载量高的患者。Objective To evaluate the management of chronic hepatitis C with PEG-IFNα-2a and ribavirin.Methods We retrospectively analyzed the virological response of 58 patients with different genotypes of hepatitis C virus（HCV） after anti-HCV management.Among them,43 cases experienced HCV genotype 1 infection,and 15 cases were infected with genotype 2.All the Patients were assigned for PEG-IFN α-2a combined ribavirin for 48 weeks,HCV RNA was tested before treatment,12 and 24 weeks post management,at the end of treatment,24 and 48 weeks after treatment was terminated.Results The rapid virological responses of the genotype 1 patients was 48.8%,obviously lower than the genotype 2（80%,P〈0.05）.After 48 weeks of termination of treatment,there were significant deviation of 53.5,and 86.7%（P〈0.05）,respectively between the two genotypes.The rapid virological responses for the patients with high viral load and lower viral load were about 46.2% and 93.8%（P〈0.05）,respectively.Obvious deviation was observed between them at the point of 48 weeks after treatment termination,they were 51.3% and 84.2%（P〈0.05）.Conclusion PEG-IFNα-2a in combination with ribavirin can effectively treat patients with different genotypes of HCV.The efficacy is better for genotype 2 than 1,and patients with low viral load than high viral load.

关 键 词：肝炎 丙型 慢性 干扰素Α-2A 利巴韦林 

分 类 号：R512.63[医药卫生—内科学]