Extended treatment duration for hepatitis C virus type 1: Comparing 48 versus 72 weeks of peginterferon-alfa-2a plus ribavirin
Extended treatment duration for hepatitis C virus type 1: Comparing 48 versus 72 weeks of peginterferon-alfa-2a plus ribavirin
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DOI：
10.1053/j.gastro.2006.02.015
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发表时间：
2006-04-01
期刊：
影响因子：
29.4
通讯作者：
Zeuzem, S
中科院分区：
文献类型：
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作者：
Berg, T;von Wagner, M;Zeuzem, S
背景和目标：丙型肝炎病毒（HCV）1型感染患者的治疗仍然是一个挑战，需要创新策略来改善治疗结果。将治疗持续时间延长至48周以上是解决这一问题的一种可能策略。研究方法：在未经治疗的HCV 1型感染患者中，研究了聚乙二醇干扰素α-2a（180 μ g/wk）联合利巴韦林（800 mg/d）治疗48周（A组，N = 230）与72周（13组，N = 225）的疗效和安全性。通过定性逆转录聚合酶链反应（灵敏度50 IU/mL）评估治疗期间和停止治疗后24周的持续病毒学应答（SVR）。结果：总体而言，两组之间的治疗结果无显著差异。A组和B组的治疗结束率和SVR率分别为71% vs 63%和53% vs 54%。在第4周和第12周时HCV-RNA水平已检测不到的患者具有极好的SVR率，范围为76%至84%，无论治疗组如何，而在第12周时仍显示HCV-RNA阳性的患者在治疗72周而不是48周时获得显著更高的SVR率（29% vs 17%，P = 0.040）。在低水平病毒血症患者中，延长治疗时间尤其有益（
Background & Aims: The treatment of patients infected with hepatitis C virus (HCV) type 1 remains a challenge necessitating innovative strategies to improve treatment outcome. The extension of treatment duration beyond 48 weeks is one possible strategy to address this problem. Methods: The efficacy and safety of 48 weeks (group A, N = 230) vs 72 weeks (group 13, N = 225) of treatment with pegylated-interferon-alfa-2a (180 mu g/wk) plus ribavirin (800 mg/day) were studied in treatment-naive patients with HCV type :1 infection. On-treatment and sustained virologic response (SVR) 24 weeks after stopping treatment was assessed by qualitative reverse-transcription polymerase chain reaction (sensitivity 50 IU/mL). Results: Overall, no significant differences could be observed in the treatment outcome between both groups. End-of-treatment and SVR rates in groups A and B were 71% vs 63% and 53% vs 54%, respectively. Patients with undetectable HCV-RNA levels already at weeks 4 and :12 had excellent SVR rates ranging from 76% to 84% regardless of treatment group, whereas patients shown to be still HCV-RNA positive at week 12 achieved significantly higher SVR rates when treated for 72 instead of 48 weeks (29% vs 17%, P =.040). A particular benefit from extended treatment duration was seen in patients with low-level viremia (