慢性丙型肝炎干扰素治疗后复发患者聚乙二醇干扰素联合利巴韦林.docVIP

慢性丙型肝炎干扰素治疗后复发患者聚乙二醇干扰素联合利巴韦林 　 作者：黄雁翔,陈新月,邹梦娜，杜晓菲 【摘要】 目的 探讨干扰素（IFN）治疗后复发的慢性丙型肝炎患者对聚乙二醇干扰素联合利巴韦林再治疗的应答情况及影响因素。 方法 对 50例IFN治疗后复发的慢性丙型肝炎患者使用聚乙二醇干扰素（PEG-IFN）α-2a联合利巴韦林再治疗进行回顾性研究。联合治疗1年，停药随访6个月，分析HCV RNA 载量、病毒基因型对联合治疗疗效的影响。 结果 50例复发患者联合再治疗后，48.0% 取得持续病毒应答（SVR）。治疗前高病毒载量（HCV RNA≥1×107拷贝/ml）患者的SVR是21.4%，低病毒载量（HCV RNAlt;1×104拷贝/ml）患者的SVR是68.8%。病毒载量高、低组间联合治疗疗效比较，差异有显著性（OR值：8.067，95% 置信区间 1.538 ～ 42.318，Plt;0.05）；HCV基因1b型与非基因1b型感染患者疗效比较，差异无显著性（OR值：2.750，95% 置信区间 0.704 ～ 10.737，Pgt;0.05）。 结论 HCV基因型与复发慢性丙型肝炎患者的聚乙二醇干扰素联合利巴韦林再治疗疗效无明显相关性；病毒载量低的复发患者再治疗疗效好于病毒载量高的患者。 【关键词】 肝炎病毒；丙型；肝炎；丙型；慢性；复发；干扰素α；聚乙烯二醇类 Retreatment with peginterferon alfa-2a plus ribavirin in patients with relapsed chronic hepatitis C 【Abstract】 Objective To evaluate the efficacy and investigate the influencing factors of the peginterferon alfa-2a （PEG-IFNα-2a） plus ribavirin retreatment for patients with chronic hepatitis C（CHC） relapsed after a previous IFN treatment.Methods A retrospective study was designed to analyze the retreatment with PEG-IFNα-2a of 50 relapsed CHC patients. The influence of HCV RNA load in serum and genotype to the therapy were analyzed. Results Among all the patients the sustained viral response （SVR） rate was 48.0%. The non-sustained viral response （NSVR） rates was 52.0%. The SVR rate of patients with high viral loads（HCV RNA≥1×107copies/ml） was 21.4%; The SVR rate of patients with low viral loads（HCV RNAlt;1×104copies/ml） was 68.8%. There was a significant differences in the SVR rate of patients between low and high viral loads（OR：8.067，95% CI 1.538 ～ 42.318， Plt;0.05）. The SVR rate of patients with HCV genotype 2a or 2b was 42.1%; The SVR rate of patients with HCV genotype 1b was 66.7%. There was not a significant differences in the SVR rate of patients between the different genotypes（OR：2.750，95%CI 0.704 ～ 10.737，Pgt;0.05）.Conclusion The CHC patients with low viral loads were more likely to show SVR compaired with those of high low viral loads. Differences in HCV genotypes may not