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慢性丙型肝炎个体化治疗及其病毒学应答效果影响因素分析 被引量:8
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作者 程茂良 王珏 +1 位作者 曾爱平 刘雪峰 《中华内科杂志》 CAS CSCD 北大核心 2012年第10期751-754,共4页
目的观察慢性丙型肝炎(CHC)IFN联合利巴韦林(RBV)方案个体化治疗的抗病毒疗效,并探讨影响其病毒学应答效果的因素。方法139例CHC患者根据各自基础条件给予IFN+RBV剂量强化治疗,在治疗前、治疗第4周、12周、24周、治疗结束时和治... 目的观察慢性丙型肝炎(CHC)IFN联合利巴韦林(RBV)方案个体化治疗的抗病毒疗效,并探讨影响其病毒学应答效果的因素。方法139例CHC患者根据各自基础条件给予IFN+RBV剂量强化治疗,在治疗前、治疗第4周、12周、24周、治疗结束时和治疗结束后24周分别进行病毒检测,根据病毒学应答情况及时进行剂量和疗程调整,并分析治疗中快速病毒学应答(RVR)和完全早期病毒学应答(cEVR)对获得持续病毒学应答(SVR)的预测作用。结果120例患者治疗第4周时检测了血清HCVRNA水平,其中84.20A,(101/120)获得了RVR;97例完成全程观察的RVR获得者中90.7%(88/97)获得了SVR。获得RVR者治疗前HCV病毒载量低于未获得RVR者[(5.883±1.246)lg拷贝/ml比(6.502±0.693)lg拷贝/ml,P=0.034]。聚乙二醇干扰素α-2a(PEG—IFNa-2a)初治患者的RVR率[87.8%(79/90)]显著高于经治患者[65.0%(13/20)],P=0.031。132例在治疗第12周时检测了血清HCVRNA水平,92.4%(122/132)患者获得了cEVR;119例完成全程观察的cEVR获得者中90.8%(108/119)获得了SVR,显著高于未获cEVR者的SVR率(5/9),P=0.007。PEG.IFNα-2a初治患者的cEVR率为94.7%(90/95),与经治患者的eEVR率[85%(17/20)]比较差异无统计学意义(P=0.158)。结论cEVR可作为SVR的预测因子。CHC的个体化治疗可以提高RVR、cEVR和SVR的获得几率。根据治疗过程中患者的病毒学应答情况及时调整药物剂量和延长维持HCVRNA阴性的疗程,应是CHC个体化治疗时的重要考虑因素。 展开更多
关键词 肝炎 丙型 慢性 个体化治疗 快速病毒学应答 完全早期病毒学应答 续病毒学应答
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Treatment of chronic viral hepatitis with nitazoxanide and second generation thiazolides 被引量:5
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作者 Emmet B Keeffe Jean-Franois Rossignol 《World Journal of Gastroenterology》 SCIE CAS CSCD 2009年第15期1805-1808,共4页
Nitazoxanide,the first thiazolide,was originally developed for the treatment of Cryptosporidium parvum.More recently,antiviral activity of nitazoxanide against hepatitis B virus(HBV)and hepatitis C virus was recognize... Nitazoxanide,the first thiazolide,was originally developed for the treatment of Cryptosporidium parvum.More recently,antiviral activity of nitazoxanide against hepatitis B virus(HBV)and hepatitis C virus was recognized in in vitro systems.These basic studies led to phaseⅡclinical trials that demonstrated the safety and efficacy of nitazoxanide in combination with peginterferon,with or without ribavirin,in the treatment of chronic hepatitis C genotype 4.The sustained virologic response rate was 79%and 80%in two studies,which was higher than the response rate of 50%with the standard of care with peginterferon plus ribavirin.In very preliminary studies of patients with chronic hepatitis B,nitazoxanide suppressed serum HBV DNA and led to loss of hepatitis B e antigen in the majority of patients and hepatitis B surface antigen in approximately a quarter of patients.Randomized controlled studies of naive and nonresponder patients with chronic hepatitis C genotype 1 are underway,new second generation and controlled release thiazolides are being developed,and future studies of patients with chronic hepatitis B are planned. 展开更多
关键词 Hepatitis C Hepatitis C virus NITAZOXANIDE
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Real world experience with Pegylated Interferon and ribavirin in Hepatitis C Genotype 1 population with favourable IL28B polymorphism
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作者 Victoria Ekstrom Rajneesh Kumar +7 位作者 Yi Zhao Mei Ling Yee Cynthia Sung Dorothy Toh Poh Yen Loh Jessica Tan Eng Kiong Teo Wan Cheng Chow 《Gastroenterology Report》 SCIE EI 2017年第3期208-212,I0002,共6页
Background and aim:Conventional hepatitis C treatment using pegylated interferon(PEG-IFN)and ribavirin is associated with significant side effects.IL28B polymorphism can predict response to treatment,with CC genotype ... Background and aim:Conventional hepatitis C treatment using pegylated interferon(PEG-IFN)and ribavirin is associated with significant side effects.IL28B polymorphism can predict response to treatment,with CC genotype having a better response.ITPA gene deficiency protects against clinically significant anaemia induced by treatment.The purpose of this study was to determine IL28B polymorphismand ITPA variation among hepatitis C genotype 1 patients who have undergone therapy with PEG-IFN and ribavirin and their association with sustained viral response(SVR).Methods:All hepatitis C genotype 1 patients who had been treated with PEG-IFN and ribavirin over the past 10 years were identified by available medical records and were contacted by letter of invitation to participate in the study.Blood samples for IL28B and ITPA genotyping were obtained.Medical records were reviewed for verification of treatment response,development of anaemia and if treatment reduction was required during the treatment.Results:A total of 61 patients with hepatitis C genotype 1 were treated with PEG-IFN and ribavirin,of whom 42 agreed to participate in the study.Mean age was 45.6±12.9 years at time of treatment,and 83.3%of patients weremales.Thirty-three(78.6%)had IL28B CC genotype,of whom 25(75.8%)obtained SVR compared with only 3 of 9(33.3%)non C/C genotype patients who achieved SVR(P=0.041).Eleven(26.1%)patients had ITPA AC genotype,and 30(71.4%)had CC genotype.There was no statistically significant difference between ITPA AC and CC genotypes in predicting clinically significant anaemia(45.5%vs 63.3%,P=0.302).Even among patients who developed anaemia,70.8%stillmanaged to achieve SVR.Treatment reduction also had no impact on SVR.Conclusion:Hepatitis C genotype 1 patients should be informed of the response rate for treatment with PEG-IFN and ribavirin in a population with favourable IL28B genotype before consideration of newer therapeutic options. 展开更多
关键词 hepatitis C pegylated interferon IL28B polymorphism sustained viral response
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