AIM： To assess the efficacy of triple therapy （peginterferon or high dose standard interferon, plus ribavirin and amantadine） in nonresponders to prior combination therapy. METHODS： A total of 196 patients were en...AIM： To assess the efficacy of triple therapy （peginterferon or high dose standard interferon, plus ribavirin and amantadine） in nonresponders to prior combination therapy. METHODS： A total of 196 patients were enrolled in a multicenter, open, randomized study. Patients were given 180 μg/wk of peginterferon-alpha-2a （40 kD） plus ribavirin （800-1000 rag/d） and amantadine （200 rag/d） for 48 wk （group A） or interferon-alpha-2a （6 MU/d for 4 wk, 3 MU/d for 20 wk, and 3 MU tiw for 24 wk） plus ribavirin （800-1000 rag/d） and amantadine （200 rag/d） for 48 wk （group B）. RESULTS： Overall sustained virologic response （SVR） was 26.6% （32.1% and 19.5% in group A and B, P = 0.057）. Baseline ALT 〉120 UI/L （OR 2.4; 95% CI：1.11 to 5.20; P = 0.026） and HCV RNA negativity after 12 wk （OR 8.7; 95% CI： 3.87 to 19.74; P 〈 0.0001） were independently associated with SVR. Therapy discontinuation occurred less frequently in patients treated with peginterferon than standard interferon （P = 0.036）. CONCLUSION： More than 25% of nonresponders to combination therapy can eradicate HCV infection when retreated with triple therapy, especially if they have a high baseline ALT and are treated with pegylated interferon.展开更多
基金Supported by partially MURST COFIN 2003, FIRST 2003-2004
文摘AIM： To assess the efficacy of triple therapy （peginterferon or high dose standard interferon, plus ribavirin and amantadine） in nonresponders to prior combination therapy. METHODS： A total of 196 patients were enrolled in a multicenter, open, randomized study. Patients were given 180 μg/wk of peginterferon-alpha-2a （40 kD） plus ribavirin （800-1000 rag/d） and amantadine （200 rag/d） for 48 wk （group A） or interferon-alpha-2a （6 MU/d for 4 wk, 3 MU/d for 20 wk, and 3 MU tiw for 24 wk） plus ribavirin （800-1000 rag/d） and amantadine （200 rag/d） for 48 wk （group B）. RESULTS： Overall sustained virologic response （SVR） was 26.6% （32.1% and 19.5% in group A and B, P = 0.057）. Baseline ALT 〉120 UI/L （OR 2.4; 95% CI：1.11 to 5.20; P = 0.026） and HCV RNA negativity after 12 wk （OR 8.7; 95% CI： 3.87 to 19.74; P 〈 0.0001） were independently associated with SVR. Therapy discontinuation occurred less frequently in patients treated with peginterferon than standard interferon （P = 0.036）. CONCLUSION： More than 25% of nonresponders to combination therapy can eradicate HCV infection when retreated with triple therapy, especially if they have a high baseline ALT and are treated with pegylated interferon.
