Factors predictive of response to interferon‐α therapy in hepatitis C virus infection
Factors predictive of response to interferon‐α therapy in hepatitis C virus infection
复制标题
丙型肝炎病毒感染中干扰素-α治疗反应的预测因素
作者：
A. Tsubota;K. Chayama;K. Ikeda;A. Yasuji;I. Koida;S. Saitoh;M. Hashimoto;S. Iwasaki;M. Kobayashi;K. Hiromitsu
为了确定可预测干扰素-α 治疗持续反应的患者依赖性因素和病毒相关因素，我们前瞻性评估了 60 名连续接受干扰素-α 标准化治疗方案的慢性丙型肝炎患者。 28名患者获得长期持续缓解，14名患者在治疗期间出现暂时缓解，但完成治疗后复发，14名患者没有缓解。四名患者因严重副作用而退出，并被排除在疗效评估之外。选择二十一个变量作为持续反应的可能预测因素，并通过多变量分析进行分析。与丙型肝炎病毒相关的变量包括治疗前的基因型和血清浓度。前者是通过使用基因型 PT、K1、K2a 和 K2b 的基因型特异性引物进行聚合酶链反应来确定的，这些基因型是从丙型肝炎病毒基因组的非结构区 5 推导出来的。后者是用竞争性聚合酶链反应技术测量的。单变量分析显示三个变量具有统计学显着性（p<0.05）：病毒基因型、治疗前病毒血症水平和 Knodell 纤维化评分。在多变量分析中，病毒基因型和 Knodell 纤维化评分与持续反应独立相关（两者 p<0.05）。 K1 和 K2a 基因型患者的持续缓解发生率分别为 40% 和 91%。我们的结论是，根据所使用的治疗方案，病毒基因型是对干扰素-α 治疗持续反应的最有用的预测因子。 （肝病学 1994；19：1088–1094。）
To determine the patient‐dependent and virus‐related factors that may predict sustained response to interferon‐α therapy, we prospectively evaluated 60 consecutive patients with chronic hepatitis C who received a standardized treatment schedule of interferon‐α. Twenty‐eight patients achieved a long‐term sustained remission, 14 patients had temporary responses during treatment but relapsed after completing it and 14 patients did not respond. Four patients dropped out because of severe side effects and were excluded from evaluation of efficacy. Twenty‐one variables were chosen as possible predictors of sustained response and were analyzed by means of multi‐variate analysis. Variables related to the hepatitis C virus included genotype and concentration in serum before treatment. The former was determined by means of the polymerase chain reaction with genotype‐specific primers for genotypes PT, K1, K2a and K2b, which were deduced from nonstructural region 5 of the hepatitis C virus genome. The latter was measured with a competitive polymerase chain reaction technique. Three variables were statistically significant (p<0.05) on univariate analysis: viral genotype, pretreatment level of viremia and Knodell's fibrosis score. In multivariate analysis viral genotype and Knodell's fibrosis score were correlated independently with a sustained response (p<0.05 for both). Incidence of sustained response was 40% and 91% in patients with genotypes K1 and K2a, respectively. We conclude that with the treatment schedule used, viral genotype was the most useful predictor of a sustained response to treatment with interferon‐α. (HEPATOLOGY 1994;19:1088–1094.)
DOI：
10.1073/pnas.87.7.2725
发表时间：
1990-04-01
影响因子：
11.1
作者：
GILLILAND, G;PERRIN, S;BUNN, HF
通讯作者：
BUNN, HF