丙肝标准治疗__培训课件.ppt

总结： 干扰素联合利巴韦林是丙肝的标准治疗方案 基因1型患者无论是否达到EVR至少应治疗48周 中国大多数丙肝为基因1型，在没有条件进行基因分型检查时宜按基因1型进行治疗 早期病毒学应答对于丙肝的治疗结局具有良好的预测价值 足量的聚乙二醇干扰素?-2a的累积剂量对SVR至关重要 谢 谢! * * * * * Slide *. The primary goal of HCV treatment is viral eradication * * * * * * * * * * * * * * Slide *. The first step towards treatment individualisation: the Hadziyannis trial Hadziyannis and colleagues conducted a large-scale, controlled study that evaluated the effectiveness of individualised combination therapy with PEGASYS? (peginterferon alfa-2a [40KD]) plus COPEGUS? (ribavirin) in patients infected with chronic HCV. Several important limitations of previous studies of pegylated interferons created the need for this trial. Although recommendations have been made to treat patients with HCV genotype 2 or 3 for 24 weeks with conventional interferon alfa in combination with ribavirin and to treat patients with HCV genotype 1 for 48 weeks, previous clinical studies with pegylated interferons have investigated only 48 weeks of therapy. In addition, no prospective studies compared the efficacy and safety of different ribavirin doses used in combination with either of the two pegylated interferons. As a result of these limitations, no evidence-based recommendations could be made regarding the optimal duration of either pegylated interferon therapy or the optimal ribavirin dose in different groups of patients. ? Hadziyannis S, et al. Ann Intern Med 2004; 140: 346 * Slide *. PEGASYS? plus COPEGUS?: individualised treatment trial design The individualised treatment study conducted by Hadziyannis and associates had four treatment arms and was designed to address the limitations of previous trials and to compare the efficacy and safety of the combination of PEGASYS? and COPEGUS?: Administered for 24 weeks vs 48 weeks Administered with low-dose COPEGUS? (800 mg/day) or standard-dose COPEGUS? (1000–1200 mg/day) A total of 1284 patients at 99 sites in 21 countries were randomised and given treatment as follows: Group A: