Peginterferon Alfa-2a Plus Ribavirin Is More Effective Than Peginterferon Alfa-2b Plus Ribavirin for Treating Chronic Hepatitis C Virus Infection
Peginterferon Alfa-2a Plus Ribavirin Is More Effective Than Peginterferon Alfa-2b Plus Ribavirin for Treating Chronic Hepatitis C Virus Infection
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DOI：
10.1053/j.gastro.2009.10.005
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发表时间：
2010-01-01
期刊：
影响因子：
29.4
通讯作者：
Leandro, Gioacchino
中科院分区：
文献类型：
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作者：
Ascione, Antonio;De Luca, Massimo;Leandro, Gioacchino
背景和目的：慢性丙型肝炎病毒（HCV）感染的患者经常使用聚乙二醇化干扰素（聚乙二醇干扰素）和利巴韦林联合治疗。本研究比较了聚乙二醇干扰素α -2a和聚乙二醇干扰素α -2b分别与利巴韦林联合使用的疗效和安全性。方法：共有320例连续未接受治疗的HCV rna阳性慢性肝炎患者，随机分配每周一次的聚乙二醇干扰素α -2a （180 μ g， A组）或聚乙二醇干扰素α -2b （1.5 μ g/kg， B组）加利巴韦林1000 mg/天（体重= 75 kg），持续48周（基因型1或4）或24周（基因型2或3）。主要终点是意向治疗的持续病毒学反应（SVR）。结果：A组患者达到SVR的比例高于B组（110/160 [68.8%]vs 87/160 [54.4%]; P = 0.008）。A组1/4基因型（51/93[54.8%]比37/93 [39.8%],P = 0.04）、2/3基因型（59/67[88.1%]比50/67 [74.6%],P = 0.046）、无肝硬化（96/127[75.6%]比75/134 [55.9%],P = 0.005）、基线HCV RNA水平为50万IU/mL（58/84[69%]比43/93 [46.2%],P = 0.002）的患者SVR高于B组。基线HCV RNA的患者中，A组和B组的SVR率无统计学差异
BACKGROUND & AIMS: Patients with chronic hepatitis C virus (HCV) infection are frequently treated with a combination of pegylated interferon (peginterferon) and ribavirin. This study compared the efficacy and safety of peginterferon alfa-2a and peginterferon alfa-2b, each in combination with ribavirin. METHODS: A total of 320 consecutive, treatment-naive, HCV RNA-positive patients with chronic hepatitis were randomly assigned to once-weekly peginterferon alfa-2a (180 mu g, group A) or peginterferon alfa-2b (1.5 mu g/kg, group B) plus ribavirin 1000 mg/day (body weight = 75 kg) For 48 weeks (genotype 1 or 4) or 24 weeks (genotype 2 or 3). The primary end point was sustained virological response (SVR) by intention-to-treat. RESULTS: More patients in group A than group B achieved an SVR (110/160 [68.8%] vs 87/160 [54.4%]; P = .008). Higher SVR rates were obtained in group A than group B among patients with genotype 1/4 (51/93 [54.8%] vs 37/93 [39.8%]; P = .04), with genotype 2/3 (59/67 [88.1%] vs 50/67 [74.6%], P =.046), without cirrhosis (96/127 [75.6%] vs 75/134 [55.9%]; P = .005), and with baseline levels HCV RNA >500,000 IU/mL (58/84 [69%] vs 43/93 [46.2%]; P = .002). SVR rates in groups A and B were not statistically different among patients with baseline HCV RNA