聚乙二醇干扰素联合利巴韦林治疗慢性丙型肝炎患者疗效及其影响因素分析

目的：观察聚乙二醇干扰素（PEG IFNα-2a）联合利巴韦林（RBV）治疗慢性丙型肝炎（CHC）患者的疗效及其影响因素。方法对331例慢性丙型肝炎患者予 PEG IFNα-2a（180μg/w 或135μg/w）联合利巴韦林（RBV）900~1200 mg/d 抗病毒治疗,疗程48～72 w,随访24 w;治疗前检测丙型肝炎病毒基因型,采用 PCR 法检测丙型肝炎病毒（HCV）RNA 水平及肝功能,以病毒学应答和生化学应答作为疗效的主要评价指标。结果在331例CHC 患者中,获得快速病毒学应答率（RVR）、早期病毒学应答率（EVR）和持续病毒学应答率（SVR）分别为65%（215/331）、94.9%（314/331）和84.9%（281/331）;对176例行基因分型,结果108例基因1型与68例非1型感染者SVR 分别为88.0%和79.4%,两组比较无明显差异;75例血清 HCV RNA 水平小于4×105 IU/ml 的患者 SVR 为93.3%,高于256例 HCV RNA 水平大于4×105 IU/ml 患者的82.4%（P〈0.05）;215例获得 RVR 的 CHC 患者的SVR 明显高于116例未获得 RVR 患者（92.6%对70.7%,x2=28.099,P=0.000）,314例获得 EVR 患者的 SVR 也明显高于17例未获得 EVR 组（88.5%对17.6%,x2=63.194,P=0.000）;50例未获得 SVR 的 CHC 患者年龄和感染丙型肝炎病毒的时间分别为（46±15）岁和（14.8±8.0）年,显著大或长于281例获得 SVR 患者[（38±13）岁和（11.5±7.7）年,P 均〈0.05]。结论聚乙二醇干扰素联合利巴韦林治疗慢性丙型肝炎疗效较好,预测临床疗效的关键因素是患者年龄、感染丙型肝炎的病程、治疗前 HCV RNA 水平及在治疗过程中能否及时获得 RVR 和 EVR。     

α干扰素联合利巴韦林治疗儿童丙型肝炎患者病毒学应答率分析

目的 探讨应用α-干扰素联合利巴韦林治疗儿童慢性丙型肝炎(CHC)患者的疗效和副反应。方法 2016年4月~2018年4月在我院肝病科就诊的42例CHC患儿被随机分为对照组21例和观察组21例,分别接受重组干扰素α-1b或聚乙二醇干扰素α-2a联合利巴韦林治疗48周。观察病毒学和生化学应答率及不良反应情况。结果 观察组快速病毒学应答、早期病毒学应答、治疗结束病毒学应答和持续病毒学应答率分别为38.1%、81.0%、90.5%和85.7%,显著高于对照组的16.7%、52.4%、69.1%和64.3%(P<0.05);在治疗4周、12周和48周时,聚乙二醇干扰素α-2a治疗组ALT复常率分别为59.5%、73.8%和83.3%,与对照组相比无统计学差异(分别为47.6%、69.0%和81.0%,P>0.05);聚乙二醇干扰素α-2a治疗组患儿流感样症状和外周血中性粒细胞数减少发生率显著高于国产干扰素治疗组(P<0.05)。结论 聚乙二醇干扰素α-2a联合利巴韦林治疗儿童CHC近期疗效较好,但副反应较大,需要根据情况,及时处理,以保证治疗的顺利进行。     

聚乙二醇干扰素-α-2b联合利巴韦林治疗慢性丙型肝炎患者的长期病毒学应答北大核心CSCD

聚乙二醇干扰素α（peg—IFN—α）联合利巴韦林（RBV）治疗慢性丙型肝炎（chronic hepatitis virus C,CHC）结束后随访24周,患者血HCVRNA阴性可认为获得了持续病毒学应答（sustained virologic response,SVR）。     

聚乙二醇干扰素α-2a联合利巴韦林治疗慢性丙型肝炎患者的病毒学应答

目的观察聚乙二醇干扰素α-2a（PEG-IFNα-2a）联合利巴韦林治疗慢性丙型肝炎（CHC）的疗效。方法回顾性分析在本院门诊接受抗病毒治疗的58例CHC患者,其中HCV-1型患者43例,HCV-2型患者15例,均给予PEG-IFNα-2a和利巴韦林治疗,疗程48周。分别在治疗前、治疗后4、12、24周,治疗终点,治疗结束后24周及48周测定患者血浆HCV RNA水平。结果 HCV-2型患者4周快速病毒学应答（RVR）率明显高于HCV-1型患者（80%vs 48.8%,P〈0.05）;治疗结束后随访48周HCV-2型患者的持续病毒应答（SVR）率明显高于1型患者（86.7%vs 53.5%,P〈0.05）。低病毒载量患者（RNA〈2×106拷贝/ml）的RVR率明显高于高病毒载量患者（93.8%vs 46.2%,P〈0.05）;治疗结束后随访48周低病毒载量患者的SVR率明显高于高病毒载量者（84.2%vs 51.3%,P〈0.05）。结论 PEG-IFNα-2a联合利巴韦林治疗CHC安全有效,对基因2型疗效优于基因1型,病毒载量低的患者疗效优于病毒载量高的患者。     

干扰素α-2b与聚乙二醇干扰素α-2a治疗低病毒载量慢性丙型肝炎快速及早期病毒学应答临床观察

目的研究干扰素类型在低病毒载量慢性丙型肝炎抗病毒治疗应答的影响。方法选择120例慢性丙型肝炎患者为研究对象,将120例患者分为聚乙二醇干扰素α-2a(派罗欣,Peg-IFN)组58例和普通干扰素α2b(凯因益生)组62例。所有患者用干扰素联合利巴韦林抗病毒治疗。Peg-IFN组选用180μg每周注射1次,普通干扰素组为600MU隔日注射1次。利巴韦林使用剂量900~1 200mg/d。疗程:达RVR之后再应用24周;达EVR之后再应用36周;对于12周未达EVR者再应用48周。对抗病毒治疗的应答情况与干扰素类型及丙肝病毒载量的关系进行回顾性分析。结果两组中,普通干扰素组RVR获得率为79%,EVR获得率为85.4%,派罗欣组的RVR获得率为81%,EVR获得率为89.6%。对于RVR的获得,x~2=0.009,P0.05,对于EVR的获得,x~2=0.036,P0.05,对于SVR的获得,x~2=0.010,P0.05,组间比较差异无统计学意义。结论在病毒载量较低的情况下,聚乙二醇干扰素α-2a与普通干扰素α-2b抗病毒治疗的RVR、EVR、SVR获得率差异无统计学意义。     

普通干扰素与聚乙二醇干扰素联合利巴韦林治疗慢性丙型肝炎疗效观察

目的研究干扰素α-1b或聚乙二醇化干扰素α-2a联合利巴韦林治疗慢性丙型肝炎的效果、安全性、耐受性及经济-效益比。方法 86例慢性丙型肝炎患者接受干扰素α-1b联合利巴韦林治疗48周;另26例接受聚乙二醇干扰素联合利巴韦林治疗48周。结果在治疗4周和12周时,干扰素α-1b治疗患者病毒学应答率分别为18.6%和61.6%,显著低于聚乙二醇干扰素治疗组的38.5%和84.6%(P﹤0.05);在治疗48周和治疗结束后随访48周时,干扰素α-1b治疗患者病毒学应答率分别为79.1%和76.7%,与聚乙二醇干扰素组的92.3%和84.6%比,无明显差异性(P﹥0.05);干扰素α-1b治疗组成本/效果比为13959.6,显著低于聚乙二醇干扰素组的54241.1;治疗期间两组ALT复常率无明显差异性(P﹥0.05);干扰素α-1b治疗的副作用相对轻于聚乙二醇干扰素。结论在我国目前国情下,干扰素α-1b联合利巴韦林治疗慢性丙型肝炎有效、安全。     

聚乙二醇干扰素α-2a联合利巴韦林治疗基因1型慢性丙型肝炎病毒学应答对复发率的预测及影响因素

目的:探讨慢性丙型肝炎基因1型患者经聚乙二醇干扰素α-2a(PEG-INFα-2a)联合利巴韦林(RBV)治疗后快速病毒学应答(RVR)、早期完全病毒学应答(cEVR)、早期部分病毒学应答(pEVR)和早期无应答(NonEVR)对复发率的预测及影响病毒应答的因素。方法:应用丙型肝炎病毒基因分型检测芯片检测103例慢性丙型肝炎基因1型患者。所有患者均给予PEG-INFα-2a联合RBV治疗,并分别检测其治疗前及治疗第4、12、48周和随访24周时检测患者的HCVRNA。分析在治疗12周内因药物不良反应而调整PEG-INFα-2a、RBV剂量的情况。结果:PEG-INFα-2a联合RBV治疗患者达RVR者为71例(68.9%)、cEVR为20例(19.4%)、pEVR为7例(6.8%)及NonEVR为5例(4.9%),治疗终点的病毒应答率(EOT)分别为95.8%、95.0%、74.4%及40.0%;持续病毒学应答(SVR)率分别为92.9%、80.0%、42.9%及20.9%;复发率分别为5.9%、15.8%、60.0%及100.0%。12周内PEG-INFα-2a和(或)RBV剂量减少与不同病毒学应答模式明显相关(P<0.05)。结论:PEG-INFα-2a联合RBV治疗慢性丙型肝炎基因1型患者早期病毒学应答不同模式对复发率有一定预测价值。治疗12周内PEG-INFα-2a和(或)RBV减量可能使病毒清除减少,是导致病毒复发率增高的重要因素之一。     

聚乙二醇干扰素α-2a和利巴韦林联合治疗慢性丙型肝炎临床观察

目的探讨慢性丙型病毒性肝炎应用聚乙二醇干扰素α-2a注射液（派罗欣）抗病毒治疗所出现的副反应及处理对策。方法慢性丙型病毒性肝炎30例病人采用聚乙二醇干扰素α-2a注射液（派罗欣）联合利巴韦林治疗12月,随访12月。结果在治疗12周时有13/15例出现血清ALT正常,血清HCV RNA阴性;早期应答率为86.6%;在治疗结束时有13/15例患者血清ALT正常,血清HCV RNA阴性（〈80copies/ml）;在随访12月时,持续应答率为76.9%,复发率为23.1%;副反应主要为不同程度的WBC下降及低热、肌肉酸痛。结论聚乙二醇干扰素α-2a可引起多种副反应,应针对所出现的副作用采用相应的护理措施及对症处理,使病人减轻不适症状,以提高治疗的依从性。     

聚乙二醇干扰素α-2a联合利巴韦林治疗慢性丙型肝炎的临床分析

目的 探讨聚乙二醇干扰素α-2a联合利巴韦林治疗慢性丙型肝炎的近期与远期疗效.方法 将38例患者随机分为治疗组20例,用聚乙二醇干扰素α-2a 180 μg皮下注射,每周1次,联合口服利巴韦林500 mg,3次/d,疗程共48周.对照组18例,肌肉注射IFN 300万U,3次/周,联合口服利巴韦林500 mg,3次/d,疗程共48周.结果 治疗组治疗后第12、24及48周患者的ALT复常率分别为45.0%、80.0%、95.0%,对照组分别为38.9%、61.0%和66.7%;HCV-RNA在治疗12、24、48周时阴转率治疗组分别为25.0%、70.0%和80.0%,对照组分别为22.2%、50.0%、77.8%;治疗组与对照组组内比较不同时点差异均有统计学意义(P<0.05或P<0.01);组间比较治疗后48周HCV-RNA转阴率差异无统计学意义(P>0.05),ALT复常率比较差异有统计学意义(P<0.05).结论 聚乙二醇干扰素α-2a联合利巴韦林治疗慢性丙型肝炎的近期与远期疗效均较好,在降低转氨酶方面也优于IFN联合利巴韦林,且用药方便,患者依从性好.     

Prospective study on early virologic response to treatment with interferon alpha-2b plus ribavirin in patients with chronic hepatitis C genotype 1b.

To evaluate the predictive value of early virologic response (EVR) of achieving a sustained virologic response (SVR), an open, prospective trial including 42 patients with chronic hepatitis C genotype 1b was performed with directly observed 24-week treatment with interferon alpha-2b plus ribavirin. We assessed the predictive values of EVR at days 3, 7, 14, and weeks 4, 8, and 12 of the SVR. The SVR in an intention-to-treat analysis was 19.0%. Patients who reached SVR presented a significantly faster reduction in plasma viral load. Stepwise multiple logistic regression analysis of the factors (gender, age, IFN dosage, ribavirin dosage, HCV RNA, ISDR, and loss of HCV RNA at week 4) revealed that loss of HCV RNA at week 4 was the only independent variable of treatment outcome (P=0.0039). A viral load at treatment day 3 above 100kIU/ml, at day 7 above 50kIU/ml, and at day 14 above 10kIU/ml was 100% predictive for virologic non-response in all except 1 patient. The cutoff levels for HCV RNA at days 3 and 14 of treatment were associated with an algorithm of the failure to detect HCV RNA after 12 weeks of treatment. In conclusions, a very early virologic response assessment could be useful for prediction of later outcome of combination therapy in chronic hepatitis C genotype 1b.     

利巴韦林血药浓度监测对基因1b型慢性丙型肝炎患者治疗效果的预测价值分析

目的 探究以利巴韦林血药浓度预测标准治疗对基因1b型慢性丙型肝炎患者治疗效果的价值。 方法 2014年1月~2016年10月我科收治的基因1b型慢性丙型肝炎患者121例,采用利巴韦林（RBV）联合聚乙二醇干扰素-α（Peg-IFNα）治疗1年,停药后随访24周。采用HPLC-MS/MS法测定血清利巴韦林浓度。采用ROC 曲线法分析指标预测获得持续病毒学应答（SVR）的价值。 结果 在随访结束时,获得SVR患者61例例,未获得SVR者60例;未获得SVR组服用RBV剂量为（10.3±2.8） mg·kg-1·d-1 显著低于获得SVR组的 （15.2±1.2） mg·kg-1·d-1（P<0.05）;获得SVR组治疗第4、12、24、48周RBV血药浓度分别为（1893.9±740.6） ng/ml、（2029.3±547.5） ng/ml、（2012.3±354.5） ng/ml、（2093.6±540.2） ng/ml,显著高于未获得SVR组的【（1223.5±722.1） ng/ml、（1286.4±685.2） ng/ml、（1305.1±692.4） ng/ml、（1121.4±655.2） ng/ml,P<0.01】;以RBV服用剂量判断获得SVR的曲线下面积（AUC）为0.96（95%CI,0.00~1.00）,当服用RBV>13.05 mg·kg-1·d-1时,其预测的敏感度为100%,特异度为85%;在治疗第12周时,以RBV血药浓度预测的AUC达到0.83（95%CI,0.68~0.97）,当RBV血药浓度>1432 ng/ml时,其预测的敏感度为100%,特异度为65%。 结论 检测利巴韦林血药浓度有助于指导标准疗法治疗基因1b型慢性丙型肝炎患者,以获得较为巩固的疗效。     

Factor VIII and IX deficiencies related to acquired inhibitors in a patient with chronic hepatitis C virus infection receiving treatment with pegylated interferon plus ribavirin

Abstract

The development of clotting factor inhibitor autoantibodies is rarely observed, but can result in a potentially life‐threatening haemorrhagic disorder. These acquired inhibitors are most frequently against factor VIII (FVIII), whilst the detection of inhibitors against other clotting factors is rarer. Inhibitors against FVIII and FIX are mostly observed in patients with classical hereditary haemophilia after receiving factor replacement therapy. We report a rare case of acquired FVIII and factor IX (FIX) inhibitors in a single, non‐haemophilic patient with chronic hepatitis C virus (HCV) infection who was receiving antiviral treatment with pegylated interferon plus ribavirin. The FVIII and FIX activities were <1% and high titres of inhibitors autoantibodies were found in his serum samples. After achieving a sustained virological response, combined immunosuppression with oral corticosteroids (prednisone) and azathioprine was introduced, erradicating the inhibitory autoantibodies. The development of these inhibitors in association with antiviral therapy for chronic hepatitis C is poorly understood, and particular attention must be given to HCV‐infected patients with worsening coagulopathy, particularly if coexistent with treatment related thrombocytopenia.     

IL28B polymorphism genotyping as predictor of rapid virologic response during interferon plus ribavirin treatment in hepatitis C virus genotype 1 patients

AIM: To clarify the association of interleukin-28B (IL28B) single nucleotide polymorphisms (SNPs) with hepatitis C virus (HCV) viremia changes for assessment of interferon (IFN) response.METHODS: A cohort of 118 Caucasian treatment-naïve HCV-G1 infected patients, treated with pegylated-IFN alpha 2a or 2b associated with ribavirin (53 responders, 65 non-responders) during the period 2010-2012, were genotyped for IL28B SNPs rs12979860 C>T and rs8099917 T>G. Genotyping was performed by real-time allelic discrimination assay. Serum HCV RNA levels were assayed at 2, 4, 12, 24 and 48 wk during therapy. Correlation between IL28B genotypes and serum HCV RNA kinetics was investigated. Multivariable logistic regression analysis was performed to identify predictors of null-response.RESULTS: Twenty-six out of 118 patients (22%) had no HCV RNA decline ≥ 1 log IU/mL at therapy week 4 (null-responders). IL28B genotype was rs8099917 (G*)/rs1297860(**) in 21/26 (80%) of null-responder patients. Using multivariate analysis, it was shown that the presence of the rs8099917 G allele was the best predictor of null-response (OR = 7.9, 95%CI: 1.99-31.18). The presence of at least one favorable genotype showed a positive predictive value of above 90% for HCV RNA reduction ≥ log at week 4. Analysis of the HCV RNA kinetics during 12 wk of therapy in patients with IL28B rs12979860 CT heterozygosis (n = 73), according to their rs8099917 status, showed that the viremia reduction was significantly different in patients carrying the rs8099917 G allele compared to those with favorable homozygosis.CONCLUSION: Our findings emphasize the association of the IL28B rs8099917 G allele with HCV. Genotyping for both IL28B SNPs is useful in clinical practice for thorough patient risk stratification based on IFN responsiveness.     

基因1型慢性丙型肝炎初治患者获得持续病毒学应答的相关因素研究

目的研究接受长效干扰素和利巴韦林治疗的基因1型慢性丙型肝炎患者获得持续病毒学应答的预测因素。方法 73例基因1型慢性丙型肝炎患者接受干扰素α-2a联合利巴韦林治疗24周或48周,随访6个月。结果 47.9%患者获得早期病毒学应答,38.4%患者获得持续病毒学应答;分析表明治疗前低病毒载量（小于8×105IU/ml）、体重指数低于25kg/m2和出现早期病毒学应答者更容易获得持续病毒学应答。结论病毒载量、体重指数和是否出现早期病毒学应答与基因1型慢性丙型肝炎初治患者获得持续病毒学应答相关。     

Effect of ribavirin in genotype 1 patients with hepatitis C responding to pegylated interferon alfa-2a plus ribavirin

BACKGROUND & AIMS: Pegylated interferon alfa-ribavirin combination is the standard treatment for chronic hepatitis C, but the mechanisms by which ribavirin enhances the rate of sustained hepatitis C virus (HCV) eradication remain unknown. We aimed to investigate the role of ribavirin in HCV clearance during therapy and to evaluate the consequences of ribavirin discontinuation in patients infected with genotype 1 hepatitis C who cleared HCV RNA at week 24. METHODS: A total of 516 patients were treated with pegylated interferon alfa-2a, 180 microg/wk, plus ribavirin, 800 mg/day. Seventy percent were RNA negative at week 24. They were randomized to continue with the combination or receive pegylated interferon alone. RESULTS: Responders at week 24 who stopped ribavirin had a significantly higher rate of breakthroughs during, and relapses after, therapy (sustained virologic response, 52.8% vs 68.2%; P = .004), but their side-effect profile and quality of life tended to improve. Multiple logistic regression analysis in the pegylated interferon alfa monotherapy group allowed identification of responders at week 24 who could stop ribavirin without losing their chance of a sustained virologic response, based on baseline viral load and age. Forty-eight weeks of ribavirin may not be needed when HCV RNA is undetectable at week 2. CONCLUSIONS: We made 3 conclusions from this study. First, ribavirin primarily acts by sustaining the virologic response to pegylated interferon alfa; second, ribavirin must be administered for the full treatment duration in most genotype 1-infected patients who respond; third, baseline parameters may help identify patients who could discontinue ribavirin or reduce the dose without losing their chance of success.     

抗丙型肝炎病毒治疗过程中甲状腺功能异常与病毒学应答关系研究*

目的探讨聚乙二醇干扰素（Peg-IFN）联合利巴韦林（RBV）治疗慢性丙型肝炎患者发生甲状腺功能异常的转归及其对抗病毒疗效的影响。方法204例（HCV基因1b型感染173例,2a型9例,3b型2例,未分型20例）慢性丙型肝炎患者应用Peg-IFN联合RBV抗病毒治疗。对于基因1型和未分型者治疗48 w,对于基因2型和3型治疗24 w。采用化学发光免疫分析法检测血清游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、超敏促甲状腺激素（sTSH）;采用间接免疫荧光法检测血清抗甲状腺球蛋白抗体（Tg-Ab）、抗甲状腺过氧化物酶抗体（TPOAb）、抗促甲状腺激素受体抗体（TRAb）、抗甲状腺微粒体抗体。结果在治疗过程中,发生甲状腺功能异常43例（19.0%）,其中甲状腺功能减退症7例（16.3%）,亚临床甲状腺功能减退症17例（39.5%）,甲状腺功能亢进症11例（25.6%）,亚临床甲状腺功能亢进症8例（18.6%）;甲状腺功能异常集中发生于治疗后24~36 w;在观察结束时,37例甲状腺功能异常患者自发或者经药物治疗后甲状腺功能恢复正常,6例患者仍需要密切监测甲状腺功能或服用抗甲状腺药物;43例甲状腺功能异常与161例无甲状腺功能异常患者RVR、EVR、ETVR、SVR、治疗结束后96 w病毒学应答率差异均无统计学意义（P>0.05）。结论Peg-IFN联合RBV治疗慢性丙型肝炎患者诱发甲状腺功能异常的发生率为19.0%,大部分是可逆的,甲状腺功能异常不影响抗病毒疗效。     

Factors associated with rapid and early virologic response to peginterferon alfa‐2a/ribavirin treatment in HCV genotype 1 patients representative of the general chronic hepatitis C population

Summary. Rapid virologic response (RVR) and complete early virologic response (cEVR) are associated with sustained virologic response to hepatitis C virus (HCV) therapy. We retrospectively examined baseline and on‐treatment factors associated with RVR (HCV RNA undetectable at week 4) and cEVR (HCV RNA undetectable at week 12, regardless of week 4 response). The analysis comprised 1550 HCV genotype‐1 patients from five clinical trials, including three enriched with difficult‐to‐treat populations, randomized to peginterferon alfa‐2a 180 μg/week plus ribavirin 1000–1200 mg/day. Overall, 15.6% achieved RVR and 54.0% achieved cEVR. Baseline factors predictive of RVR were serum HCV RNA ≤ 400 000 IU/mL (OR: 7.34; P < 0.0001), alanine aminotransferase >3 × ULN (OR: 2.01; P < 0.0001), non‐cirrhotic status (OR: 1.92; P = 0.0087), age ≤ 40 years (OR: 1.56; P = 0.0085), white non‐Latino ethnicity (OR: 1.41; P = 0.0666) and individual study (P < 0.0001). These factors plus body mass index ≤ 27 kg/m² were predictive of cEVR. After adjusting for these factors, mean on‐treatment ribavirin dose >13 mg/kg/day was predictive of RVR (OR: 1.69; P = 0.005) and cEVR (OR: 1.24; P = 0.09), whereas peginterferon alfa‐2a dose reduction was not. Greater decreases in haematologic parameters were observed in patients who achieved cEVR compared with patients who did not. In conclusion, several baseline and on‐treatment factors were associated with RVR and cEVR to peginterferon alfa‐2a plus ribavirin in difficult‐to‐treat HCV genotype‐1 patients, providing important prognostic information on the antiviral response in a patient cohort that is reflective of the general chronic hepatitis C population.     

Early virologic response after peginterferon alpha-2a plus ribavirin or peginterferon alpha-2b plus ribavirin treatment in patients with chronic hepatitis C

Patients infected with hepatitis C virus (HCV) genotype 1 and with serum HCV RNA concentrations over 800 000 IU/mL have relatively low rates of virologic response to pegylated interferons. The 2 forms of pegylated interferon have different pharmacokinetic profiles, and pilot studies comparing them have yielded varying results. We compared the virologic response to 12 weeks of treatment with peginterferon alpha-2a plus ribavirin vs peginterferon alpha-2b plus ribavirin in 380 patients who were infected with HCV genotype 1 and had high viral loads. We observed no between-group differences in viral load reduction over time and no differences in the percentage of patients treated with peginterferon alpha-2a or peginterferon alpha-2b plus ribavirin who achieved early virologic response (EVR), defined as >/=2-log reduction in HCV RNA concentration or undetectable HCV RNA at 12 weeks (66%vs 63%). Serum levels of interferon were more frequently below the level of quantitation in patients treated with peginterferon alpha-2b plus ribavirin (58-68%) than in those treated with peginterferon alpha-2a plus ribavirin (1-2%). Patients treated with peginterferon alpha-2b plus ribavirin had higher rates of discontinuation for safety reasons (6%vs 1%). In conclusion, a substantial percentage of patients infected with HCV genotype 1 and high viral load can achieve EVR when treated with peginterferon and ribavirin. The 2 pegylated interferons showed comparable anti-HCV activity during the first 12 weeks of treatment when combined with the same doses of ribavirin (1000-1200 mg/day), but discontinuations for safety reasons were higher in the patients treated with peginterferon alpha-2b plus ribavirin.     

Superior response to pegylated interferon and ribavirin in Asians with chronic hepatitis C

Purpose  

Reported sustained virological response (SVR) rates in Asians with chronic hepatitis C (CHC) exceed those of other ethnic groups, but differences in body weight across races potentially confound this observed superior response. Our aim was to determine whether Asian race independently predicts SVR within a multicultural clinic setting.