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首页> 外文期刊>Hepatology: Official Journal of the American Association for the Study of Liver Diseases >Treatment of acute hepatitis C in human immunodeficiency virus-infected patients: the HEPAIG study.
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Treatment of acute hepatitis C in human immunodeficiency virus-infected patients: the HEPAIG study.

机译：HEPAIG研究：在人类免疫缺陷病毒感染的患者中治疗急性丙型肝炎。

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Acute hepatitis C continues to be a concern in men who have sex with men (MSM), and its optimal management has yet to be established. In this study, the clinical, biological, and therapeutic data of 53 human immunodeficiency virus (HIV)-infected MSM included in a multicenter prospective study on acute hepatitis C in 2006-2007 were retrospectively collected and analyzed. The mean hepatitis C virus (HCV) viral load at diagnosis was 5.8 +/- 1.1 log(10) IU/mL (genotype 4, n = 28; genotype 1, n = 14, genotype 3, n = 7). The cumulative rates of spontaneous HCV clearance were 11.0% and 16.5% 3 and 6 months after diagnosis, respectively. Forty patients were treated, 38 of whom received pegylated interferon and ribavirin. The mean duration of HCV therapy was 39 +/- 17 weeks (24 +/- 4 weeks in 14 cases). On treatment, 18/36 (50.0%; 95% confidence interval 34.3-65.7) patients had undetectable HCV RNA at week 4 (RVR), and 32/39 (82.1%; 95 confidence interval 70.0-94.1) achieved sustained virological response (SVR). SVR did not correlate with pretreatment parameters, including HCV genotype, but correlated with RVR (predictive positive value of 94.4%) and with effective duration of HCV therapy (64.3% for 24 +/- 4 weeks versus 92.0% for longer treatment; P = 0.03). Conclusion: The low rate of spontaneous clearance and the high SVR rates argue for early HCV therapy following diagnosis of acute hepatitis C in HIV-infected MSM. Pegylated interferon and ribavirin seem to be the best option. The duration of treatment should be modulated according to RVR, with a 24-week course for patients presenting RVR and a 48-week course for those who do not, irrespectively of HCV genotype.
机译：急性丙型肝炎仍然是与男性发生性关系（MSM）的男性所关注的问题，其最佳治疗方法尚待确定。在这项研究中，回顾性分析并分析了2006-2007年多中心急性丙型肝炎前瞻性研究中53例感染人类免疫缺陷病毒（HIV）的MSM的临床，生物学和治疗数据。诊断时平均丙型肝炎病毒（HCV）病毒载量为5.8 +/- 1.1 log（10）IU / mL（基因型4，n = 28;基因型1，n = 14，基因型3，n = 7）。诊断后3个月和6个月内，HCV自发清除的累积率分别为11.0％和16.5％。治疗了40名患者，其中38名接受了聚乙二醇化干扰素和利巴韦林。 HCV治疗的平均持续时间为39 +/- 17周（14例为24 +/- 4周）。在治疗中，有18/36（50.0％; 95％置信区间34.3-65.7）患者在第4周（RVR）时检测不到HCV RNA，而32/39（82.1％; 95置信区间70.0-94.1）获得了持续的病毒学应答（ SVR）。 SVR与包括HCV基因型在内的预处理参数无关，但与RVR（预测阳性值为94.4％）和HCV治疗有效期相关（24 +/- 4周为64.3％，而更长治疗为92.0％; P = 0.03）。结论：自发清除率低和SVR率高表明在感染HIV的MSM中诊断为急性丙型肝炎后应进行早期HCV治疗。聚乙二醇化干扰素和利巴韦林似乎是最佳选择。治疗的持续时间应根据RVR进行调整，对于呈现RVR的患者，应进行24周的疗程，对于没有HCV基因型的患者，应针对不接受RVR的患者进行48周的疗程。

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