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聚乙二醇干扰素联合利巴韦林治疗经治慢性丙型肝炎患者的回顾性分析 预览 被引量:7

A retrospective study of peginterferon plus ribavirin for treatment of chronic hepatitis C in patients who had undergone previous antiviral therapy
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摘要 目的:评价聚乙二醇干扰素(peginterferon,pegIFN)联合利巴韦林治疗经治慢性丙型肝炎(chronic hepatitis C,CHC)患者的病毒学应答及安全性.方法:根据CHC患者经治方案的不同分组,分析再次以pegIFN联合利巴韦林治疗后的病毒学应答:快速病毒学应答(rapid virologic response,RVR)、早期病毒学应答(early virologic response,EVR)、治疗结束时病毒学应答(end-of-treatment virologic response,ETR)、持续病毒学应答(sustained virologic response,SVR)、复发率及中止治疗比率,并分析影响临床结局的影响因素.结果:(1)既往采用pegIFN联合利巴韦林治疗的经治患者,再次以该方案治疗后获得RVR、EVR、ETR、SVR的比率相对偏低(分别为21.1%vs40.5%,26.3%vs43.2%,47.4%vs56.8%,31.6%vs46.0%),与IFN组比较无统计学差异(P〉0.05);(2)既往以pegIFN联合利巴韦林治疗的经治患者,再次以该方案治疗后的复发率相对较高,但与IFN组比较无统计学差异(33.3%vs19.0%,P〉0.05);(3)经治CHC患者获得ETR可能为其获得SVR的有利因素(OR=20.43,P=0.004).结论:对经治CHC患者再次采用pegIFN联合利巴韦林抗病毒仍可取得相对有效的病毒学应答,既往以pegIFN联合利巴韦林抗病毒的经治CHC患者,不支持继续以相同方案抗病毒,获得ETR可能为该部分患者获得SVR的有利因素. AIM: To evaluate the virologic responses and safety of peginterferon plus ribavirin therapy for treatment of chronic hepatitis C (CHC) in patients who had undergone previous antiviral therapy.METHODS: All patients were divided into two groups based on the type of previously used in- terferon. Virologic responses, including rapid vi-rologic response (RVR), early virologic response (EVR), end-of-treatment virologic response (ETR) and sustained virologic response (SVR), relapse rate and discontinuation rate were assessed after retreatment with peginterferon plus ribavirin. RESULTS: For CHC patients previously treated with peginterferon plus ribavirin, retreatment by the same regimen might be associated with lower RVR, EVR, ETR and SVR rates (21.1% vs 40.5%, 26.3% vs 43.2%, 47.4% vs 56.8%, 31.6% vs 46.0%) and a higher relapse rate (33.3% vs 19.0%), but no significance was found compared with those treated with standard interferon (all P 〉 0.05). Achieving EVR might be a positive factor for achieving SVR in patients previously treated with interferons (IFNs) (OR = 20.43, P=0.004). CONCLUSION: Peginterferon plus ribavirin therapy is effective for CHC patients previously treated with IFNs; however, retreatment with the same regimen for CHC patients previously treated with peginterferon plus ribavirin is not recommended. Achieving EVR might be a posi- tive factor for achieving SVR in patients previ- ously treated with IFNs.
作者 徐庆年 杨宗国 陆云飞 陈晓蓉 Qing-Nian Xu, Zong-Guo Yang, Yun-Fei Lu, Xiao-Rong Chen( Shanghai Public Health Clinical Center, Fudan Uni- versity, Shanghai 201508, China)
机构地区 上海市
出处 《世界华人消化杂志》 CAS 北大核心 2013年第19期1797-1802,共6页 World Chinese Journal of Digestology
基金 国家十二五科技重大专项基金资助项目,No.2012ZX10004301004
关键词 聚乙二醇干扰素 利巴韦林 经治 慢性丙型肝炎 回顾性分析 Peginterferon Ribavirin Retreatment Chronic hepatitis C Retrospective study
作者简介 徐厌年,副主任医师,主要从事急慢性肝胆疾病的基础与临床的研究 通讯作者:陈晓蓉,主任医师,201508,上海市金山区漕廊公路2901号,上海市(复旦大学附属)公共卫生临床中心.xiaorong3chen@l63.com
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