慢性丙型肝炎干扰素个体化治疗的临床观察

Clinical observation of individualized therapeutic programs with interferon on chronic hepatitis C

目的观察不能耐受标准剂量干扰素治疗方案的部分丙型肝炎患者干扰素个体化给药的疗效,探索不同剂量干扰素治疗丙型肝炎的方法。方法收集多种原因不能耐受标准剂量干扰素治疗方案的丙型肝炎患者共28例,给予个体化低剂量干扰素(普通干扰素0.8～3 MIU/d,隔日1次)联合利巴韦林0.6～0.9 g/d治疗,疗程48周。结果 89.29%(25/28)患者可耐受低剂量干扰素联合利巴韦林长期治疗。不同时间节点的病毒学应答率为:4周病毒学应答率(RVR)为7.04%,12周病毒学应答率(EVR)为17.85%、24周病毒学应答率53.85%、48周病毒学应答率为60.00%。停药后24周病毒学应答率(SVR)为48.00%。结论抗丙型肝炎病毒治疗可以改善肝功能,从而提高患者对高效抗逆转录病毒治疗的耐受性。

Objective To investigate the effect of individualized therapeutic programs with interferon in patients with chronic hepatitis C （CHC） who could’t tolerate the therapy with standard dose of interferon and explore the methods of therapy with different doses of interferon in patients with CHC. Methods Total of 28 cases of patients with CHC who could’t tolerate the therapy with standard dose of interferon received the individual low-dose interferon （ordinary IFN 0.8-3 MIU once every other day） in combination with ribavirin 0.6-0.9 g/d. The course of treatment was 48 weeks. Results There were 89.29%（25/28） patients with CHC could tolerate low-dose interferon in combination with ribavirin in long-term treatment. For patients treated for 4 weeks, the rapid virological response （RVR） rate was 7.04%. For those treated for 12 weeks, the early virological response （EVR） rate was 17.85%. For those treated for 24 weeks, the virological response rate was 53.85%. For those treated for 48 weeks, the virological response rate was 60.00%. All patients were followed-up for 24 weeks after the end of the treatment, and the sustained virological response （SVR） rate was 48.00%. Conclusions Anti-HCV therapy could improve liver function of the patients with HCV infection, consequently, it can improve the tolerability of highly active antiretroviral therapy.