中国丙肝.ppt

R2：一项亚洲基因1型慢丙肝的独立研究中，200例慢丙肝患者分别接受聚乙二醇干扰素α-2a 180μg联合利巴韦林1000-1200mg治疗24周、48周，停药随访24周 R3：的研究设计：国际多中心、随机对照研究中，1121例患者随机接受聚乙二醇干扰素α-2a180μg/周联合利巴韦林（1000/1200mg）、干扰素a-2b 3MIU联合利巴韦林（1000/1200mg）治疗48周，随访24周 R4:基因lb型或者基线高病毒载量初治慢性丙型肝炎患者438 例, 给予聚乙二醇干扰素a-2aa180 ug/w联合利巴韦林抗病毒治疗, 治疗疗程由治疗12 周时病毒学应答情况决定。治疗12 周H CV R N A 15IU/ m L 患者给予总共48 周疗程治疗. R2 Recommended treatment for hepatitisCvirus genotype 1 (HCV-1) patients is PEGinterferon plus ribavirin for 48 weeks. We assessed whether treatment duration of 24 weeks is as effective as standard treatment in HCV-1 patients with a rapid virological response (RVR; seronegative for hepatitis C virus [HCV] RNA at 4 weeks). Two hundred HCV-1 patients were randomized (1:1) to either 24 or 48 weeks of PEGinterferon-alpha-2a (180 g/week) and ribavirin (1000-1200 mg/day) with a 24-week follow-up. The primary endpoint was a sustained virological response (SVR; seronegative for HCV RNA at 24-week follow-up). Overall, the 48-week arm had a significantly higher SVR rate (79%) than the 24-week arm (59%, P 0.002). For 87 (43.5%) patients with an RVR, the 24-week arm had a lower SVR rate [88.9%; 95% confidence interval (CI): 80%-98%] than the 48-week arm (100%, P 0.056). For 52 patients with low baseline viremia (400,000 IU/mL) and an RVR, the 24-week arm had rates (CI) of relapse and SVR of 3.6% (3%-11%) and 96.4% (89%-103%), respectively, which were comparable to those of the 48-week arm (0% and 100%) with difference (CI) of 3.6% (7.2%-6.6%) and3.6% (14.3% to0.6%), respectively. Multivariate analysis in all patients showed that RVR was the strongest independent factor associated with an SVR, followed by treatment duration, mean weight–based exposure of ribavirin, and baseline viral load. Conclusion: HCV-1 patients derive a significantly better SVR from 48 weeks versus 24 weeks of PEGinterferon/ribavirin even if they attain an RVR. Both 24 and 48 weeks of therapy can achieve highSVRrates (96%) inHCV-1patients with low viral loads and an RVR.