Predicting sustained virological responses in chronic hepatitis C patients treated with peginterferon alfa-2a (40 KD)/ribavirin
Predicting sustained virological responses in chronic hepatitis C patients treated with peginterferon alfa-2a (40 KD)/ribavirin
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DOI：
10.1016/j.jhep.2005.04.009
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发表时间：
2005-09-01
影响因子：
25.7
通讯作者：
Reddy, KR
中科院分区：
文献类型：
--
作者：
Ferenci, P;Fried, MW;Reddy, KR
背景/目标：在治疗期间预测持续病毒学应答（SVR）将允许临床医生识别最有可能从治疗中获益的患者。1121例成人慢性丙型肝炎患者接受聚乙二醇干扰素α-2a（40 KD）180 μ g/周联合安慰剂或利巴韦林治疗48周的回顾性分析（1000/1200 mg/天）或干扰素α-2b 3 MIU每周三次加利巴韦林。结果：67%接受聚乙二醇干扰素α-2a（40 KD）/利巴韦林治疗的患者出现早期病毒学应答第12周（HCV RNA阴性或降低>= 2 log（10））在第72周出现SVR（HCV RNA < 50 IU/mL）。阴性预测值（NPV）为97%。SVR的可能性随着HCV RNA抑制的速度而增加。在第4周快速病毒学应答的患者中获得了最高的SVR率，但相应的NPV（74%）对于决策标准来说太低。在12周早期病毒学应答的患者中，接受80%计划利巴韦林剂量的患者的SVR率约低20%< 80 % compared with patients who received >。结论：早期持续抑制HCV复制预示SVR。对于12周后HCV RNA没有>= 2 log（10）降低的患者，可以考虑停止治疗。(c)2005年欧洲肝脏研究协会。Elsevier B. V.出版，保留所有权利。
Background/Aims: Prediction of sustained virological response (SVR) during treatment would allow clinicians to identify patients most likely to benefit from therapy.Methods: Retrospective analysis of data from 1121 adults with chronic hepatitis C treated for 48 weeks with peginterferon alfa-2a (40 KD) 180 mu g/week plus placebo or ribavirin (1000/1200 mg/day), or interferon alfa-2b 3 MIU three times/week plus ribavirin in a randomized, multinational, study.Results: 67% of patients treated with peginterferon alfa-2a (40 KD)/ribavirin with early virological responses (HCV RNA negative or >= 2 log(10) decrease) at week 12 had SVRs at week 72 (HCV RNA < 50 IU/mL). The negative predictive value (NPV) was 97%. The probability of an SVR increased with the rapidity of HCV RNA suppression. The highest SVR rates were achieved in patients with rapid virological responses at week 4, but the corresponding NPV (74%) is too low for a decision criterion. In patients with early virological responses by week 12, the SVR rate was approximate to 20 % lower in those who received < 80 % compared with patients who received > 80 % of the planned ribavirin dose.Conclusions: Early, sustained suppression of HCV replication portends an SVR. Cessation of treatment may be contemplated in patients without a >= 2 log(10) reduction in HCV RNA after 12 weeks. (c) 2005 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.