Successful treatment of acute hepatitis C virus in HIV positive patients using the European AIDS Treatment Network guidelines for treatment duration
Successful treatment of acute hepatitis C virus in HIV positive patients using the European AIDS Treatment Network guidelines for treatment duration
复制标题
DOI：
10.1016/j.jcv.2011.08.020
复制
发表时间：
2011-12-01
影响因子：
8.8
通讯作者：
Baily, Guy
中科院分区：
文献类型：
--
作者：
Dorward, Jienchi;Garrett, Nigel;Baily, Guy
背景：HIV阳性患者中急性丙型肝炎病毒（HCV）的发病率正在上升。欧洲艾滋病治疗网络（NEAT）（1）总结的最新研究表明，聚乙二醇干扰素α（PEG-IFN α）和利巴韦林可导致约60-80%的患者出现持续病毒学应答（SVR）。关于何时开始治疗以及24周或48周的治疗是否会导致更好的结果，仍存在争议。目的：评估一种治疗策略对HIV阳性患者急性HCV感染的有效性，其中患者在4周时检测不到HCV RNA，根据NEAT指南，快速病毒学应答（RVR）的患者接受24周的治疗，而没有接受PEG-IFN α和利巴韦林的患者接受48周的治疗。2006年12月至2010年5月诊断为急性HCV感染的HIV阳性患者的回顾性队列研究。对接受PEG-IFN α和利巴韦林急性治疗的患者进行HCV RNA水平监测和结局评估。对于没有接受急性治疗的患者，推迟和最近可用的HCV RNA的原因recorded.Results：22例患者接受了PEG-IFN α和利巴韦林的急性治疗。12例患者达到RVR，治疗24周，10例患者无RVR，治疗48周。2例患者停止治疗（由于不良反应[AE]和12周时未能充分抑制HCV RNA）。所有20例完成治疗的患者均有SVR。结论：我们91%的高SVR率支持新的NEAT治疗持续时间建议。(C)2011 Elsevier B. V.保留所有权利。
Background: The incidence of acute hepatitis C virus (HCV) in HIV-positive patients is rising. Recent studies summarized by the European AIDS Treatment Network (NEAT)(1) show that pegylated interferon alpha (PEG-IFN alpha) and ribavirin can lead to a sustained virological response (SVR) in approximately 60-80% of patients. Controversy remains on when to start treatment and whether 24 or 48 weeks of treatment lead to better outcomes.Objectives: To assess the effectiveness of a treatment strategy for acute HCV infection in HIV-positive patients, in which patients with undetectable HCV RNA at 4 weeks (rapid virological response, RVR) receive 24 weeks, while those without receive 48 weeks of PEG-IFN alpha and ribavirin, as per the NEAT guidelines.Study design: A retrospective cohort study of HIV-positive patients diagnosed with acute HCV infection between December 2006 and May 2010. Those who received acute treatment with PEG-IFN alpha and ribavirin had HCV RNA levels monitored and outcomes evaluated. For patients who did not receive acute treatment, the reason for deferral and most recent available HCV RNA were recorded.Results: Twenty-two patients received acute treatment with PEG-IFN alpha and ribavirin. Twelve patients achieved RVR and had 24 weeks treatment, 10 patients had no RVR and had 48 weeks treatment. Two patients discontinued treatment (due to adverse effects [AEs] and failure to suppress HCV RNA sufficiently at 12 weeks). All 20 patients who completed treatment had SVR.Conclusion: Our high SVR rate of 91% supports the new NEAT treatment duration recommendations. (C) 2011 Elsevier B.V. All rights reserved.