HCV基因1型感染者接受聚乙二醇α-2a/利巴韦林治疗24周后的疗效观察

来源 :世界核心医学期刊文摘(胃肠病学分册) | 被引量 : 0次 | 上传用户:tx9yky76
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Approximately one third of hepatitis C virus (HCV) genotype 1 patients achieved a sustained virological response (SVR) after 24 weeks of treatment with peginterferon α-2a (40 kd) plus ribavirin in a randomized, multinational trial. We aimed to identify factors associated with a rapid virological response (RVR) at week 4 (HCV RNA < 50 IU/mL) and a SVR (HCV RNA < 50 IU/mL at the end of follow-up) in these patients. Stepwise multiple logistic regression analysis was used to explore the prognostic factors for a RVR and SVR in genotype 1 patients treated for 24 weeks. Fifty-one of 216 (24%) genotype 1 patients in the 24-week treatment groups had a RVR. SVR rates were considerably higher in patients without a RVR (89%vs. 19%, respectively). Patients with a baseline HCV RNA of less than 200,000 IU/mL (OR 9.7, 95%CI 4.2-22.5; P < .0001) or 200,000-600,000 IU/mL (OR 3.6, 95%CI 1.5-9.1; P = .0057) were more likely to achieve a RVR than those with HCV RNA greater than 600,000 IU/mL. HCV subtype (1b vs. 1a) was also independently associated with RVR (OR 1.8, 95%CI 0.9-3.7; P = .0954). RVR (OR 23.7 vs. no RVR, 95%CI 9.1-61.7) and baseline HCV RNA less than 200,000 IU/mL (OR 2.7 vs. >600,000 IU/mL, 95%CI 1.1-6.3; P < .026) were significant and independent predictors of SVR in patients treated for 24 weeks. In conclusion, patients infected with HCV genotype 1 and treated with peginterferon α-2a/ ribavirin sustained a RVR 24%of the time. This portends an 89%probability of a SVR after 24 weeks of treatment. Approximately one third of hepatitis C virus (HCV) genotype 1 patients achieved a sustained virological response (SVR) after 24 weeks of treatment with peginterferon α-2a (40 kd) plus ribavirin in a randomized, multinational trial. with a rapid virological response (RVR) at week 4 (HCV RNA <50 IU / mL) and a SVR (HCV RNA <50 IU / mL at the end of follow- up) in these patients. Stepwise multiple logistic regression analysis was used to explore the prognostic factors for a RVR and SVR in genotype 1 patients treated for 24 weeks. Fifty-one of 216 (24%) genotype 1 patients in the 24-week treatment groups had a RVR. SVR rates were significantly higher in patients without Patients with a baseline HCV RNA of less than 200,000 IU / mL (OR 9.7, 95% CI 4.2-22.5; P <.0001) or 200,000-600,000 IU / mL (89% vs 19% OR 3.6, 95% CI 1.5-9.1; P = .0057) were more likely to achieve a RVR than those with HCV RNA greater than 600,000 IU / mL. HCV subtype (1b vs. 1a) was also independently associated with RVR (OR 1.8, 95% CI 0.9-3.7; P = .0954). RVR (OR 23.7 vs. no RVR, 95% CI 9.1-61.7) and baseline HCV RNA less than 200,000 IU / mL (OR 2.7 vs.> 600,000 IU / mL, 95% CI 1.1-6.3; P <.026) were significant and independent predictors of SVR in patients treated for 24 weeks. 1 and treated with peginterferon α-2a / ribavirin sustained a RVR 24% of the time. This portends an 89% probability of a SVR after 24 weeks of treatment.
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