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首页> 外文期刊>Hepatology: Official Journal of the American Association for the Study of Liver Diseases >Identifying hepatitis C virus genotype 2/3 patients who can receive a 16-week abbreviated course of peginterferon alfa-2a (40KD) plus ribavirin.
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Identifying hepatitis C virus genotype 2/3 patients who can receive a 16-week abbreviated course of peginterferon alfa-2a (40KD) plus ribavirin.

机译：确定可接受16周的peginterferon alfa-2a（40KD）加利巴韦林治疗的丙型肝炎病毒基因型2/3患者。

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摘要

The objective of this analysis was to compare sustained virological response (SVR) and relapse rates in patients with a rapid virological response (RVR, HCV RNA <50 IU/mL at week 4) randomized to 24 or 16 weeks of treatment with peginterferon alfa-2a (40KD) 180 microg/week plus ribavirin 800 mg/day in the multinational ACCELERATE study. The analysis was restricted to patients who received treatment for 80% or more of the planned duration. Of 1309 eligible patients, 863 individuals (65.9%) achieved an RVR and were included in this analysis (458 assigned to 16 weeks and 405 assigned to 24 weeks). The overall SVR rate was significantly higher in patients randomized to 24 weeks of treatment (91% versus 82%; P = 0.0006) and among patients infected with genotype 2 (92% versus 81%; P = 0.0010) but not genotype 3 (90% versus 84%; P = 0.1308). Relapse rates were significantly lower among all patients randomized to 24 weeks of treatment: overall (6% versus 15%, P < 0.0001); in those infected with genotype 2 (5% versus 17%, P = 0.0001), and genotype 3 (7% versus 14%, P = 0.0489). SVR rates in patients with a viral load of 400,000 IU/mL or less randomized to 24 and 16 weeks of treatment were similar, 95% and 91% (P = 0.2012). Significant pretreatment predictors of SVR included assignment to 24 weeks of treatment (P = 0.0006), absence of advanced fibrosis on liver biopsy (P = 0.0032), lower HCV RNA level (P = 0.0017), and lower body weight (P < 0.0001). CONCLUSION: The standard 24-week regimen of peginterferon alfa-2a (40KD) plus ribavirin is significantly more effective than an abbreviated 16-week regimen in genotype 2/3 patients who achieve an RVR. Abbreviated regimens may be considered in patients with a low baseline viral load who achieve an RVR.
机译：这项分析的目的是比较快速病毒学应答（RVR，HCV RNA在第4周时HCV RNA <50 IU / mL）患者的持续病毒学应答（SVR）和复发率，随机分配至接受聚乙二醇干扰素α-治疗24周或16周在跨国ACCELERATE研究中2a（40KD）180微克/周加利巴韦林800毫克/天。该分析仅限于接受了计划持续时间80％或更多的治疗的患者。在1309名符合条件的患者中，有863人（65.9％）达到了RVR，并被纳入该分析（458人分为16周，405人分为24周）。随机治疗24周的患者和感染基因型2的患者（分别为92％相对于81％; P = 0.0010）但不是基因型3（90）的总体SVR率显着更高（91％比82％; P = 0.0006） ％对84％; P = 0.1308）。在随机分配至治疗24周的所有患者中，复发率显着较低：总体（6％对15％，P <0.0001）;感染基因型2（5％vs 17％，P = 0.0001）和基因型3（7％vs 14％，P = 0.0489）的患者。随机分配至治疗24周和16周的病毒载量为400,000 IU / mL或更低的患者，其SVR率相近，分别为95％和91％（P = 0.2012）。 SVR的重要预治疗指标包括治疗24周（P = 0.0006），肝活检中无晚期纤维化（P = 0.0032），HCV RNA水平较低（P = 0.0017）和较低体重（P <0.0001） 。结论：在获得RVR的基因型2/3患者中，peginterferon alfa-2a（40KD）加利巴韦林的标准24周治疗方案明显优于16周的简短治疗方案。对于基线病毒载量较低且达到RVR的患者，可以考虑采用简化治疗方案。

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