Adherence to combination therapy enhances sustained response in genotyp-1-infected patients with chronic hepatitis C
Adherence to combination therapy enhances sustained response in genotyp-1-infected patients with chronic hepatitis C
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DOI：
10.1053/gast.2002.35950
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发表时间：
2002-10-01
期刊：
影响因子：
29.4
通讯作者：
Albrecht, JK
中科院分区：
文献类型：
--
作者：
McHutchison, JG;Manns, M;Albrecht, JK
背景与目的：在人类免疫缺陷病毒感染中，患者坚持处方抗病毒治疗可增强应答。我们评估了干扰素或聚乙二醇干扰素联合利巴韦林联合治疗对慢性丙型肝炎患者的影响。方法：我们评估了剂量减少对干扰素α-2b联合利巴韦林(n=1010)或聚乙二醇α-2b 1.5 mg/kg/周+利巴韦林(n=511)的持续病毒学应答(SVR)的影响。实际进行的治疗是从配药/退药记录和病人日记中核实的。确定了两组患者：(1)在预期治疗时间的80%或以上期间同时接受干扰素和利巴韦林总剂量80%的患者和(2)在临床试验期间接受减少剂量(干扰素或聚乙二醇干扰素α-2b和利巴韦林剂量的80%)的患者显示出更高的持续应答率。我们的结果表明，坚持将提高实现最初病毒学应答的可能性。坚持超过12-24周将只对那些取得如此早期病毒学应答的患者有利。
Background & Aims: Patient adherence to prescribed antiviral therapy in human immunodeficiency virus infection enhances response. We evaluated the impact of adherence to combination therapy with interferon or peginterferon plus ribavirin in chronic hepatitis C patients. Methods: We assessed the effect of dose reduction on sustained virologic response (SVR) from prior trials with interferon alpha-2b plus ribavirin (n = 1010) or peginterferon alpha-2b 1.5 mug/kg/week plus ribavirin (n = 511). The actual treatment administered was verified from drug dispensing/return records and patient diaries. Two groups were defined: (1) patients who received greater than or equal to80% of both their total interferon and ribavirin doses for greater than or equal to80% of the expected duration of therapy and (2) patients who received reduced doses (80% of their interferon or peginterferon alpha-2b and ribavirin dosage for the duration of treatment in the setting of a clinical trial exhibit enhanced sustained response rates. Our results suggest that adherence will enhance the likelihood of achieving an initial virologic response. Adherence beyond 12-24 weeks will be advantageous only for those patients who have achieved such an early virologic response.