A study of best positive predictors for sustained virologic response to interferon alpha plus ribavirin therapy in naive chronic hepatitis C patients.
A study of best positive predictors for sustained virologic response to interferon alpha plus ribavirin therapy in naive chronic hepatitis C patients.
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DOI：
10.1186/1471-230x-9-5
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发表时间：
2009-01-20
影响因子：
2.4
通讯作者：
Riazuddin S
中科院分区：
文献类型：
--
作者：
Idrees M;Riazuddin S
本研究的目的是确定慢性丙型肝炎感染患者接受干扰素α和利巴韦林联合治疗的持续病毒学应答（SVR）率和与应答率相关的各种因素。对2001年至2007年在该中心收集的患者数据进行了回顾性分析。在731名连续患者中，对400名符合研究标准的患者进行了评价，随后用干扰素α 2b（每周皮下注射3次，每次3 MU）和利巴韦林（每天口服800-1200 mg）的组合进行治疗。治疗持续24周或48周，此后对患者进行额外6个月的随访。记录治疗结束反应（ETR）、SVR和不良反应。在400名患者中，394名完成了整个疗程，6名患者在第2个月停止治疗。超过67%的患者在治疗结束时有反应，16%的患者复发。在所有接受治疗的患者中，47.6%的男性和56.7%的女性有持续的病毒应答，总的合并持续病毒应答率为50.5%。46.5%的患者出现快速反应。在多变量逻辑回归分析中，慢病毒学应答者（调整后OR 2.6 [95%CI 1.9-3.7]），HCV基因型1&4（调整OR 2.4 [95% CI 1.7-3.5]），治疗前病毒载量> 0.2 MIU/mL（校正OR 2.2 [95% CI 1.8-4.2]）、Panjabi族（校正OR 1.6 [95% CI 1.0-3.2]）和年龄> 40岁（校正OR 1.5 [95% CI 0.9-2.4]）是无应答的独立危险因素。副作用常见且可耐受，仅1.5%的患者停止治疗。在这个国家，SVR的最佳阳性预测因子是：快速病毒学应答，HCV基因型2和3，年龄< 40岁，种族Pashtoons和治疗前病毒载量< 0.2百万IU/mL。
The aim of this study was to determine the rate of sustained virological response (SVR) and various factors associated with response rates in chronic hepatitis C infected patients treated with interferon alpha and ribavirin combination therapy. A retrospective review of patients data collected at this Centre from 2001 to 2007 was performed. Out of 731 consecutive patients 400 patients that fulfilled the study criteria were evaluated and subsequently treated with a combination of interferon alpha 2b (3 MU subcutaneously three injections weekly) and ribavirin (800–1200 mg orally daily). Treatment were administered for either 24 weeks or 48 weeks and patients were followed for an additional 6 months thereafter. End of the treatment response (ETR), SVR and side effects were recorded. Out of 400 patients, 394 completed the entire treatment course and six patients discontinued treatment at month 2. Over 67% responded at the end of treatment and 16% suffered relapse. Among all treated patients, 47.6% males and 56.7% females had sustained viral response with a total combined sustained viral response rate of 50.5%. Rapid response was seen in 46.5% patients. In a multivariate logistic regression analysis, slow virological responders (adjusted OR 2.6 [95% CI 1.9–3.7]), HCV genotype 1&4 (adjusted OR 2.4 [95% CI 1.7–3.5]), pre-treatment viral load > 0.2 MIU/mL (adjusted OR 2.2 [95% CI 1.8–4.2]), Panjabi ethnic group (adjusted OR 1.6 [95% CI 1.0–3.2]) and Age > 40 years (adjusted OR 1.5 [95% CI 0.9–2.4]) were independent risk factors for non response. Side effects were usual and tolerable and only 1.5% discontinued the treatment. The best positive predictor for SVR in this country are: rapid virologic response, HCV genotype 2 & 3, age < 40 years, ethnic race Pashtoons and pre-treatment viral load < 0.2 million IU/mL.