小剂量长效干扰素联合利巴韦林治疗肝移植术后丙肝复发

The therapy efficacy of small dose peg - interferon plus ribavirin on recurrent Hepatitis C patients of post liver transplantation

目的探讨肝移植术后丙肝复发患者接受小剂量长效干扰素联合利巴韦林治疗的疗效。方法我院2002-06至2012-04肝移植术后丙肝复发患者,接受聚乙二醇干扰素(派罗欣)90μg/周,2周后升至135μg/周,利巴韦林600 mg/d,抗病毒治疗6、12、24周时监测血HCV-RNA滴度、肝功能、血常规及临床表现。结果肝移植术后丙肝复发患者接受小剂量长效干扰素联合利巴韦林治疗共22例,其中早期病毒学应答率(early virological response,EVR)达90.9%,治疗结束病毒学应答率(end-of-treatment virological response,ETVR)100.0%,持续病毒应答率(sustained virological response,SVR)为81.8%。治疗24周后,患者胆碱酯酶的活性较治疗前显著升高(P=0.013)。血红蛋白、血小板及白细胞轻度降低分别占54.5%、68.2%和27.3%,未见严重的发热、皮肤损害及脱发。结论小剂量长效干扰素联合利巴韦林治疗肝移植术后丙肝复发的EVR、ETVR及SVR率较高,肝脏合成能力增强,不良反应轻微。

Objective To study therapy efficacy of small dose peg-interferon plus ribavirin on recurrent Hepatitis C patients of post liver transplantation.Methods The patients were accepted the therapy of Pegasys 90ug / week,after two weeks 135 ug / week,Ribavirin 600mg / day,who were recurrence with Hepatitis C post liver transplantation from June,2002 to April,2012 in our hospital.The titer of HCV-RNA,liver function,blood routine and clinical presents were monitoring at 6th week,12 th week and 24th week during the therapy.Results There were 22 cases were accepted the therapy of small dose peg-interferon plus ribavirin.The rate of early virological response（EVR） was 90.9%.The rate of end-of-treatment virological response（ETVR） was 100.0%.The sustained virological response（SVR） was 81.8%.There was significant increase of the activity of cholinesterase after 24 weeks treatment（P =0.013）.The mild abnormality was taken place in the blood routine,hemoglobin 54.5%,platelet 68.2% and leucocyte 27.3%.Severe fever,skin lesion and alopecia were not taken place in these cases.Conclusions The rates of EVR,ETVR and SVR are high,and the liver synthetic ability of patients are elevated without serious side-effect after treated small dose peg-interferon plus ribavirin.