Response-guided therapy for patients with chronic hepatitis who have high viral loads of hepatitis C virus genotype 2
Response-guided therapy for patients with chronic hepatitis who have high viral loads of hepatitis C virus genotype 2
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对丙型肝炎病毒基因型 2 病毒载量较高的慢性肝炎患者进行反应指导治疗
DOI：
10.1111/j.1872-034x.2011.00956.x
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发表时间：
2012
期刊：
影响因子：
4.2
通讯作者：
Kawada N
中科院分区：
文献类型：
--
作者：
Yamaguchi Y;Tamori A;Tanaka Y;Iwai S;Kobayashi S;Fujii H;Morikawa H;Hagihara A;Enomoto M;Kawada N
目的：我们评估反应引导疗法对2型丙型肝炎病毒（HCV）患者的疗效。方法：我们研究了105例HCV基因型2载量高于5.0 Log IU/mL的患者，这些患者接受了超过75%的聚乙二醇化干扰素加利巴韦林的目标剂量。在快速病毒反应（RVR，第4周未检测到HCV RNA）的患者中，14人选择治疗16周（A组），28人选择治疗24周（B组）。在非RVR患者中，40人选择24周治疗（C组），19人选择48周治疗（D组）。结果：A组和B组患者均获得持续病毒应答（SVR）。临床特征在C组和D组之间无显著差异，但在开始治疗后一周HCV RNA消失的患者比例在D组更高（P= 0.0578）。在HCV RNA在第5 - 8周消失的患者中，34例C患者中有28例（82%）达到SVR， 11例D患者中有10例（91%）达到SVR。在HCV RNA在第9 - 12周消失的患者中，5例C患者中有1例（20%）达到SVR， 8例D患者中有5例（63%）达到SVR（无统计学意义）。结论：RVR患者经16周联合治疗可达到足够的抗病毒效果。延长治疗不能显著提高非RVR患者的SVR率。
Aim:We evaluated the efficacy of response‐guided therapy in patients with hepatitis C virus (HCV) genotype 2.Methods:We studied 105 patients with an HCV genotype 2 load of higher than 5.0 Log IU/mL who received more than 75% of the target dose of pegylated interferon plus ribavirin. Among patients with rapid viral response (RVR; no HCV RNA detected at week 4), 14 selected 16 weeks of therapy (group A), and 28 selected 24 weeks of therapy (group B). Among non‐RVR patients, 40 selected 24 weeks of therapy (group C), and 19 selected 48 weeks of therapy (group D).Results:All patients in group A and B achieved a sustained viral response (SVR). Clinical characteristics did not differ significantly between groups C and D. However, the proportion of patients in whom HCV RNA disappeared at a later week after starting treatment was higher in group D (P= 0.0578). SVR rate was 73% in C, and 79% in D. Among patients in whom HCV RNA disappeared between weeks 5 and 8, SVR was achieved in 28 (82%) of 34 patients in C and 10 (91%) of 11 patients in D. Among patients whose HCV RNA disappeared between weeks 9 and 12, SVR was achieved in one (20%) of five patients in C and five (63%) of eight patients in D (not statistically significant).Conclusions:16 weeks of combination therapy could achieve an adequate antiviral effect for RVR patients. Extending therapy could not significantly improve SVR rate in non‐RVR patients.