Results of interferon-based treatments in Alaska Native and American Indian population with chronic hepatitis C.
Results of interferon-based treatments in Alaska Native and American Indian population with chronic hepatitis C.
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DOI：
10.3402/ijch.v75.30696
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发表时间：
2016
影响因子：
1.3
通讯作者：
McMahon BJ
中科院分区：
文献类型：
--
作者：
Livingston SE;Townshend-Bulson LJ;Bruden DJ;Homan CE;Gove JE;Plotnik JN;Simons BC;Spradling PR;McMahon BJ
在本土人群中使用干扰素治疗丙型肝炎病毒效果的报道很少。确定阿拉斯加原住民和美洲印第安人(AN/AI)人群中基于干扰素的治疗结果。在1995年至2013年对1,379名慢性丙型肝炎病毒感染者的结果研究中，我们检查了189人接受标准干扰素、干扰素+利巴韦林、聚乙二醇化干扰素+利巴韦林和三联疗法的治疗结果。对于接受聚乙二醇化干扰素和利巴韦林治疗的患者，也检查了患者特征对反应的影响。持续病毒学应答(SVR)标准干扰素为16.7%(3/18)，标准干扰素+利巴韦林为29.7%(11/37)。在接受聚乙二醇化干扰素和利巴韦林治疗的119人中，61人获得SVR(51.3%)，其中46人中有10人(21.7%)，51人中有38人(74.5%)，22人中有13人(59.1%)。通过多因素分析，聚乙二醇化干扰素组的SVR与女性(p=0.002)、估计感染持续时间(p=0.034)和丙型肝炎病毒基因分型(p<；0.0001)相关。在接受聚乙二醇化干扰素和利巴韦林治疗的1型患者中，由于副作用，停药率很高(52.2%)。在接受聚乙二醇化干扰素、利巴韦林、替拉维韦或博西普韦治疗的15例1型患者中，有7例获得SVR(46.7%)。我们成功地用聚乙二醇化干扰素治疗了携带基因2和3的AN/AI患者。然而，对于基因1的患者，SVR较低，停药率较高。
There have been few reports of hepatitis C virus (HCV) treatment results with interferon-based regimens in indigenous populations. To determine interferon-based treatment outcome among Alaska Native and American Indian (AN/AI) population. In an outcomes study of 1,379 AN/AI persons with chronic HCV infection from 1995 through 2013, we examined treatment results of 189 persons treated with standard interferon, interferon plus ribavirin, pegylated interferon plus ribavirin and triple therapy with a protease inhibitor. For individuals treated with pegylated interferon and ribavirin, the effect of patient characteristics on response was also examined. Sustained virologic response (SVR) with standard interferon was 16.7% (3/18) and with standard interferon and ribavirin was 29.7% (11/37). Of 119 persons treated with pegylated interferon and ribavirin, 61 achieved SVR (51.3%), including 10 of 46 with genotype 1 (21.7%), 38 of 51 with genotype 2 (74.5%) and 13 of 22 with genotype 3 (59.1%). By multivariate analysis, SVR in the pegylated interferon group was associated with female sex (p=0.002), estimated duration of infection (p=0.034) and HCV genotype (p<0.0001). There was a high discontinuation rate due to side effects in those treated with pegylated interferon and ribavirin for genotype 1 (52.2%). Seven of 15 genotype 1 patients treated with pegylated interferon, ribavirin and telaprevir or boceprevir achieved SVR (46.7%). We had success with pegylated interferon-based treatment of AN/AI people with genotypes 2 and 3. However, there were low SVR and high discontinuation rates for those with genotype 1.