应答为指导的干扰素方案治疗6a型慢性丙型肝炎  

Response-guided therapy with interferon in patients chronically infected with HCV genotype 6a

作　　者：陈凤娟[1] 郭凤霞[1] 邵晓琼[2] 蔡庆贤[2] 赵志新[2] CHEN Feng-juan GUO Feng-xia SHAO Xiao-qiong CAI Qing-xian ZHAO Zhi-xin(Guangzhou Eighth People＇s Hospital, Guangzhou , Guangdong 510060 The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510630, China)

机构地区：[1]广州市第八人民医院肝病科,广东广州510060 [2]中山大学附属第三医院感染性疾病科,广东广州510630

出　　处：《热带医学杂志》2017年第6期751-754,共4页Journal of Tropical Medicine

基　　金：广东省自然科学基金(2015A030310427)

摘　　要：目的探讨以应答为指导(RGT)的聚乙二醇干扰素α-2a联合利巴韦林(Peg-IFNα-2a+RBV)方案在基因6a型慢性丙型肝炎(CHC)中的效果。方法 2014年1月至2015年12月间连续入组基因6a型CHC患者共60例(优化组),接受Peg-IFNα-2a+RBV抗病毒治疗,其中达到快速病毒学应答(RVR)的患者疗程缩短至24周,未达到RVR者疗程为48周。同时以2012年1月至2013年12月期间,接受48周固定疗程的Peg-IFNα-2a+RBV治疗的所有基因6a型CHC患者为对照组(56例)。结果优化组患者快速病毒学应答(RVR)、治疗终点病毒学应答(ETR)、持续病毒性应答(SVR)、停药后复发发生率分别为67.2%、87.9%、82.8%和5.2%,与对照组的71.4%、82.1%、80.4%、1.8%比较,差异均无统计学意义(P>0.05)。优化组与对照组获得RVR患者的最终SVR率(92.3%vs 87.5%,),差异亦无统计学意义(P=0.479)。优化组除血象异常发生率低于对照组外,其他差异均无统计学意义。结论获得RVR的基因6a型CHC患者,其接受24周与48周疗程Peg-IFNα-2a+RBV治疗均能取得较高的SVR率。Objective To investigate the management of response-guided regimens with pegylated interferon α-2a andribavirin in patients chronically infected with HCV genotype 6a. Methods From January 2014 to December 2015,a totalof 60 treatment-na？ve HCV genotype 6a patients were consecutive enrolled（optimization group）and treated with pegylatedinterferon（Peg-IFN）α-2a 180 mcg/week and ribavirin（RBV）800-1 200 mg/day;those who achieved rapid virologicalresponse（RVR）were assigned to 24 week treatment duration,others were treated with 48 week duration. A control group,in which 56 genotype 6a patients treated with fixed 48 week duration of pegylated interferon α-2a and ribavirin fromJanuary 2012 to December 2013 were paired. Results There was no statistical difference in sustained virological response（SVR）between optimization and control groups（48/58 vs. 45/56,82.8% vs. 80.4%,P=0.741）. In the optimization andcontrol groups,67.2% and 71.4% of cases achieved RVR（P=0.628）. SVR of the optimization and control groups withRVR were 92.3%（24-weeks）,and 87.5%（48-weeks）,respectively. Patients in optimization group suffered less skin rashand hemogram abnormality. Conclusion Overall,RVR was achieved in the majority of genotype 6 patients and patientsreceived 24 weeks and 48 weeks of treatment Peg-IFNα-2a ＋ RBV treatment both could achieve a higher SVR rate.

关 键 词：聚乙二醇干扰素 慢性丙型肝炎 快速病毒性应答 持续病毒性应答 

分 类 号：R512.63[医药卫生—内科学]