Directly observed therapy for the treatment of hepatitis C virus infection in current and former injection drug users
Directly observed therapy for the treatment of hepatitis C virus infection in current and former injection drug users
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DOI：
10.1111/j.1440-1746.2007.05032.x
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发表时间：
2007-09-01
影响因子：
4.1
通讯作者：
Conway, Brian
中科院分区：
文献类型：
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作者：
Grebely, Jason;Raffa, Jesse D.;Conway, Brian
背景和目的：目前很少有研究调查目前和以前的吸毒者丙型肝炎病毒（HCV）感染的治疗。考虑到这一点，我们试图评估干扰素α-2b的抗病毒疗效。（IFN α-2b）或聚乙二醇化干扰素α-2b（PEG-IFN α-2b）和利巴韦林（RBV）在参加直接观察治疗（DOT）计划的注射吸毒者（IDU）中的作用，如通过持续病毒学应答（SVR）测量的。病毒血症HCV感染IDU，丙氨酸氨基转移酶（ALT）> 1.5x正常上限（ULN），提供24-48周（基于HCV基因型）RBV（800-1200 mg/天，基于体重）与IFN α-2b（300万IU，每周三次）一起沿着治疗，当其变得可用时，用PEG-IFN α-2b（1.5 IG/kg，每周一次）代替。直接观察所有进样。结果：总体而言，40例患者（33名男性）接受IFN α-2b（12）或PEG-IFN α-2b（28），55%的HCV基因型2或3。只有14人停止治疗，5人由于毒性，6人由于非法药物使用，3人没有达到早期病毒学应答。在意向治疗分析中，总体SVR为55%（22/40），基因型2/3的受试者为64%（14/22）。在> 6（50%）或
Background and Aim: There are few studies investigating the treatment of hepatitis C virus (HCV) infection in current and former drug users. With this in mind, we sought to evaluate the antiviral efficacy of interferon alpha-2b (IFN alpha-2b) or pegylated-interferon alpha-2b (PEG-IFN alpha-2b) and ribavirin (RBV) in injection drug users (IDU) enrolled in a directly observed therapy (DOT) program, as measured by sustained virologic response (SVR).Methods: Viremic HCV-infected IDU, with alanine aminotransferase (ALT) > 1.5x upper limit of normal (ULN) were offered 24-48 week (based on HCV genotype) therapy with RBV (800-1200 mg/day, based on weight) along with IFN alpha-2b (3 million IU thrice weekly) replaced by PEG-IFN alpha-2b (1.5 ig/kg once weekly) as it became available. All injections were directly observed. The primary endpoint was SVR.Results: Overall, 40 patients (33 males) received IFN alpha-2b (12) or PEG-IFN alpha-2b (28), 55% with HCV genotypes 2 or 3. Only 14 discontinued therapy, 5 due to toxicity, 6 due to illicit drug use and 3 did not achieve an early virologic response. In an intent-to-treat analysis, the overall SVR was 55% (22/40), 64% (14/22) in subjects with genotypes 2/3. There was no significant difference in response rates among those with > 6 (50%) or