Treatment of chronic hepatitis C with PEG-interferon alpha-2b and ribavirin:: 24 weeks of therapy are sufficient for HCV genotype 2 and 3
Treatment of chronic hepatitis C with PEG-interferon alpha-2b and ribavirin:: 24 weeks of therapy are sufficient for HCV genotype 2 and 3
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DOI：
10.1055/s-2003-39649
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发表时间：
2003-06-01
影响因子：
1.3
通讯作者：
Manns, MP
中科院分区：
文献类型：
--
作者：
Cornberg, M;Hüppe, D;Manns, MP
感染HCV基因型2和3的慢性丙型肝炎患者在80%以上的病例中可以成功治疗。已经表明，用标准干扰素α和利巴韦林的24周tiw治疗期对于这些患者是足够的。然而，最近的多中心研究调查聚乙二醇干扰素和利巴韦林的效果，对所有患者使用48周的时间表，而不考虑HCV基因型。因此，我们前瞻性地研究了在两个不同地点用聚乙二醇干扰素α-2b（1.0 - 1.5 μ g/kg oiw）和利巴韦林（每天1- 1.2 g）治疗54名HCV基因型2和3的患者24周的疗效。29例患者在Herne（私人诊所）接受治疗，25例患者在汉诺威（医学院）接受治疗。随访结束后，46例（85%）患者在意向治疗分析中显示病毒学持续应答。只有4例患者表现出病毒学治疗失败（3例复发，1例突破），2例患者不依从，在每个中心，1例患者因不良事件停止治疗。两个研究中心的治疗反应没有差异，尽管赫恩的患者仅接受1.0 μ g/kg PEG-IFN α-2b治疗，而汉诺威的患者接受1.5 μ g/kg PEG-IFN α-2b治疗。总之，本研究的缓解率与最近发表的多中心试验的48周治疗期结果没有差异。因此，我们建议当PEG-IFN α-2b与利巴韦林联合使用时，治疗所有HCV基因型2和3的患者仅24周。
Patients with chronic hepatitis C infected with HCV genotype 2 and 3 can be successfully treated in more than 80% of cases. It had been shown that a 24 week tiw treatment period with standard interferon alpha and ribavirin is sufficient for these patients. However, the recent multicenter studies investigating the effect of pegylated interferons and ribavirin used a 48 week schedule for all patients irrespective of the HCV genotype. Thus, we prospectively investigated the efficacy of a 24 week treatment period with pegylated interferon alpha-2b (1,0-1,5 mug/kg oiw) and ribavirin (1-1,2 g daily) in 54 patients with HCV-genotype 2 and 3 at two different sites. 29 patients were included in Herne (private practice) and 25 patients were treated in Hannover (Medical School). After the end of follow-up 46 (85%) patients showed a virological sustained response in the intent to treat analysis. Only four patients demonstrated a virological treatment failure (3 relapse, 1 breakthrough), two patients were non-compliant, and at each center therapy was stopped in one patient due to adverse events. There was no difference regarding treatment response between both sites, even though the patients in Herne were treated only with 1,0 mug/kg PEG-IFN alpha-2b, while patients in Hannover received 1,5 mug/kg PEG-IFN alpha-2b. In conclusion, the response rates of this study do not differ from the results of the 48 week treatment period of the recently published multicentre trials. Thus, we suggest treating all patients with HCV-genotype 2 and 3 for only 24 weeks when PEG-IFN alpha-2b is used in combination with ribavirin.