聚乙二醇干扰素α-2a(40kD)/利巴韦林治疗的慢性丙型肝炎患者的持续性病毒应答预测

作     者：Ferenci P. FriedM.W. Shiffman M.L. 李宏宇 

作者机构：Univ. Klinik für Innere Medizin IV AKH Waehri- nger Guertel 18- 20 A 1090 Wien Austria 

出 版 物：《世界核心医学期刊文摘（胃肠病学分册）》 (Core Journals in Gastroenterology)

年 卷 期：2005年第1卷第12期

页      面：48-49页

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 100401[医学-流行病与卫生统计学] 10[医学] 

主　　题：慢性丙型肝炎 kD 干扰素α 病毒应答 病毒学应答 持续性 丙肝患者 病毒学反应 丙肝病毒 阴性预测值 

摘      要：Background/Aims: Prediction of sustained virologicalresponse (SVR) during treatment would allow clinicians to identify patients most likely to benefit from therapy. Methods: Retrospective analysis of data from 1121 adults with chronic hepatitis C treated for 48 weeks with peginterferon alfa- 2a (40 KD) 180 μ g/week plus placebo or ribavirin (1000/1200 mg/day), or interferon alfa- 2b 3 MIU three times/week plus ribavirin in a randomized, multinational, study. Results: 67% of patients treated with peginterferon alfa- 2a (40 KD)/ribavirin with early virological responses (HCV RNA negative or ≥ 2 log10 decrease) at week 12 had SVRs at week 72 (HCV RNA 50 IU/mL). The negative predictive value (NPV) was 97% . The probability of an SVR increased with the rapidity of HCV RNA suppression. The highest SVR rates were achieved in patients with rapid virological responses at week 4, but the corresponding NPV (74% ) is too low for a decision criterion. In patients with early virological responses by week 12, the SVR rate was ≈ 20% lower in those who received 80% compared with patients who received ≥ 80% of the planned ribavirin dose. Conclusions: Early, sustained suppression of HCV replication portends an SVR. Cessation of treatment may be contemplated in patients without a ≥ 2 log10 reduction in HCV RNA after 12 weeks.