Rapid and early virological response to chronic hepatitis C treatment with IFN α2b or PEG-IFN α2b plus ribavirin in HIV/HCV co-infected patients
Rapid and early virological response to chronic hepatitis C treatment with IFN α2b or PEG-IFN α2b plus ribavirin in HIV/HCV co-infected patients
复制标题
HIV/HCV 合并感染患者使用 IFN α2b 或 PEG-IFN α2b 加利巴韦林治疗慢性丙型肝炎的快速和早期病毒学反应
作者：
C. Payan;A. Pivert;P. Morand;S. Fafi;F. Carrat;S. Pol;P. Cacoub;C. Perronne;F. Lunel
背景和目的：美国和欧洲推荐的治疗慢性丙型肝炎患者使用聚乙二醇化干扰素和利巴韦林治疗慢性丙型肝炎的方法是基于丙型肝炎病毒核糖核酸在12周时下降2log10。方法：我们检测了HIV/丙型肝炎混合感染患者的快速病毒学应答(RVR；在治疗开始后的W2和W4)。使用丙型肝炎病毒RNA测量(Versant HCVRNA3.0，Cobas Amplicor HCV2.0)，对ANRS HC02 RIBAVIC试验中的323名患者进行RVR研究，比较干扰素α2b 3MU×3/周和聚乙二醇化干扰素α2b1.5μ/kg/周，两者均联合利巴韦林800 mg/d，持续48周。结果：持续病毒学应答(SVR)的阳性预测值和阴性预测值分别为W4未检出(97%)和W12(99%)>2log10。在所有患者中，以W4的HCVRNA水平>46万IU/ml和W12的HCVRNA水平>39000uI/ml作为临界值，均可预测非SVR，而与丙型肝炎病毒基因型和治疗方法无关。结论：我们提出了一种基于使用丙型肝炎病毒RNA的RVR阈值的新算法，该算法可以很好地预测W4早期的非SVR。
Background and aims: An algorithm based on a 2 log10 decline in hepatitis C virus (HCV) RNA at week (W) 12 has been proposed in US and European recommendations for the management of patients with chronic hepatitis C treated with pegylated-interferon and ribavirin. Methods: We examined rapid virological response (RVR; at W2 and W4 after the initiation of therapy) in HIV/HCV co-infected patients. Using HCV RNA measurements (Versant HCV RNA 3.0, Cobas Amplicor HCV 2.0), RVR was studied in 323 patients from the ANRS HC02 RIBAVIC trial, comparing interferon α2b 3 MU ×3/week with pegylated interferon α2b 1.5 μg/kg/week, each combined with ribavirin 800 mg/day over 48 weeks. Results: The best positive and negative predictive values of sustained virological response (SVR) were obtained with an undetectable HCV RNA at W4 (97%) and with more than a 2 log10 decrease at W12 (99%), respectively. Prediction of non-SVR was obtained in all patients by using HCV RNA cut-off levels above 460 000 IU/ml at W4 and above 39 000 UI/ml at W12 irrespective of the HCV genotype and arm of treatment. Conclusion: We propose a new algorithm based on RVR thresholds using HCV RNA that allows for excellent prediction of non-SVR as early as W4.
是否存在定量测定 HCV RNA 以预测干扰素治疗慢性 HCV 感染后无反应的最佳时间？
影响因子：
25.7
作者：
McHutchison,J;Blatt,L;Sedghi-Vaziri,A;Russell,J;Schmid,P;Conrad,A
通讯作者：
Conrad,A
影响因子：
158.5
作者：
Chung, RT;Andersen, J;van der Horst, C
通讯作者：
van der Horst, C