High predictive value of early viral kinetics in retreatment with peginterferon and ribavirin of chronic hepatitis C patients non-responders to standard combination therapy
High predictive value of early viral kinetics in retreatment with peginterferon and ribavirin of chronic hepatitis C patients non-responders to standard combination therapy
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DOI：
10.1016/j.jhep.2006.10.016
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发表时间：
2007-04-01
影响因子：
25.7
通讯作者：
Marcellin, Patrick
中科院分区：
文献类型：
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作者：
Moucari, Rami;Ripault, Marie-Pierre;Marcellin, Patrick
背景/目标：为了评估聚乙二醇干扰素α-2b和利巴韦林的疗效在连续三年的慢性丙型肝炎患者，治疗试验外，复发或无应答干扰素和利巴韦林combination.Methods：一百五十四例患者进行了评估。标准联合治疗有101例无应答者和53例复发者。患者重新治疗与聚乙二醇干扰素α-2b 1. 5微克/公斤/周加利巴韦林1000-1200毫克/天在48 weeks.Results：44例（28.6%）达到持续病毒学反应（SVR）。快速（第4周）和早期（第12周）病毒学应答具有较高的SVR阴性预测值（分别为94%和97%），但阳性预测值相对较低（分别为52%和49%）。复发者的SVR率（58.5%）高于无应答者（13%），p < 0.0001。在无反应者中，基因型非1且轻度或中度纤维化的患者的SVR升高至50%。在多变量分析中，预测SVR的因素有：干扰素联合利巴韦林治疗后复发、轻度或中度纤维化、基因型非1和基线病毒载量
Background/Aims: To evaluate the efficacy of peginterferon alfa-2b and ribavirin in unselected consecutive patients with chronic hepatitis C, treated outside of trials, who were relapsers or non-responders to interferon and ribavirin combination.Methods: One hundred and fifty-four patients were evaluated. There were 101 non-responders and 53 relapsers to standard combination therapy. Patients were retreated with peginterferon alfa-2b 1.5 mu g/kg/wk plus ribavirin 1000-1200 mg/day during 48 weeks.Results: Forty-four patients (28.6%) achieved sustained virological response (SVR). Rapid (week 4) and early (week 12) virological response had high negative predictive values of SVR (94% and 97%, respectively); however positive predictive values were relatively low (52% and 49%, respectively). Relapsers had higher SVR rates (58.5%) than non-responders (13%) p < 0.0001. In non-responders, SVR raised to 50% in patients with genotype non-1 and mild or moderate fibrosis. In multivariate analysis, predictors of SVR were: relapse after interferon plus ribavirin combination, mild or moderate fibrosis, genotype non-1 and baseline viral load