Evaluation on the efficacy of PEG-IFNα-2b plus ribavirin treatment for acute hepatitis C in different times

doi:10.3969/j.issn.1673-8640.2015.10.002

Abstract

Abstract: Objective

To investigate the efficacy influence of polyethylene glycol interferon alpha-2b(PEG-IFNα-2b)plus ribavirin treatment for acute hepatitis C(AHC) in different times.

Methods

All 40 patients with AHC were classified into Ⅰ(viremia lasted less than 3 months, 23 cases) and Ⅱ(viremia lasted for 3 months to 6 months, 17 cases) groups, and they were administrated PEG-IFNα-2b (80 μg/week) combined with ribavirin (800mg/d) for 24 weeks. Before the treatment(at the end of week 0) and after the treatment (at the ends of week 12, 24 and 48), serum hepatitis C virus (HCV) RNA, alanine aminotransferase (ALT), aspartate aminotransferase (AST), hyaluronic acid (HA) and laminin (LN) were determined. The results were analyzed statistically.

Results

The HCV RNA, ALT, AST, HA and LN before the treatment in Ⅰ and Ⅱ groups were different statistically(P<0.05). After the treatment, the levels of HCV RNA, ALT, AST, HA and LN in Ⅰ group decreased. Compared with those before the treatment of Ⅰ group and after the treatment of Ⅱ group, there was statistical significance (P<0.05). After the treatment, the early virological response(EVR)rate and virological response at end of therapy(ETVR) rate, sustained virological response(SVR)rate, biochemical response(BR) rate and the recovery rates of HA and LN of Ⅰ group were higher than those after the treatment of Ⅱ group (P<0.05). The relapse rate in Ⅱ group after the treatment was higher than that in Ⅰ group after the treatment(P<0.05).

Conclusions

The PEG-IFNα-2b plus ribavirin treatment for AHC could prevent the occurrence of chronic hepatitis C and liver fibrosis. The clinical curative efficacy of AHC with viremia lasted less than 3 months with this therapeutic schedule is better than that with viremia lasted for 3 months to 6 months. It is easy to relapse in AHC patients with viremia lasted for 3 months to 6 months after the treatment.

Key words: Polyethylene glycol interferon alpha-2b, Ribavirin, Treatment time, Curative efficacy, Acute hepatitis C

CLC Number:

R446.61

ZHAO Hua, JIN Hangyun, PAN Tonghui, FANG Yucai. Evaluation on the efficacy of PEG-IFNα-2b plus ribavirin treatment for acute hepatitis C in different times[J]. Laboratory Medicine, 2015, 30(10): 975-979.

Figures/Tables 3

References 13

[1]	张青文. 急性丙型病毒性肝炎19例临床分析[J].实用医技杂志,2014,21(2):184-185.
[2]	中华医学会肝病学分会,中华医学会传染病与寄生虫病学分会.丙型肝炎防治指南[J].中华传染病杂志,2004,22(2):135-136.
[3]	段学章,张敏.丙型病毒性肝炎防治新进展[M].北京:人民军医出版社,2010:57-65.
[4]	LOGUERCIO C, FEDERICO A, MASARONE M, et al.The impact of diet on liver fibrosis and on response to interferon therapy in patients with HCV-related chronic hepatitis[J]. Am J Gastroenterol, 2008, 103(12): 3159-3166.
[5]	SANTANTONIO T, WIEGAND J, GERLACH JT.Acute hepatitis C: current status and remaining challenges[J]. J Hepatol, 2008, 49(4): 625-633.
[6]	RAO HY, SUN DG, JIANG D, et al.IL28B genetic variants and gender are associated with spontaneous clearance of hepatitis C virus infection[J]. J Viral Hepat, 2012, 19(3): 173-181.
[7]	ZHANG YX, WU WJ, ZHANG YZ, et al.Noninvasive assessment of liver fibrosis with combined serum aminotransferase/platelet ratio index and hyaluronic acid in patients with chronic hepatitis B[J]. World Gastroenterol, 2008, 14(46): 7117-7121.
[8]	曾颖玲,毛惠南.安络化纤丸联合干扰素和利巴韦林治疗丙型肝炎肝纤维化的临床研究[J].国际医药卫生导报,2013,19(4):543-545.
[9]	DETERDING K, GRÜNER N, BUGGISCH P, et al. Delayed versus immediate treatment for patients with acute hepatitis C: a randomized controlled non-inferiority trial[J]. Lancet Infect Dis, 2013, 13(6): 497-506.
[10]	MICHAEL PM,钱燕.丙型肝炎治疗进展[J].肝脏,2008,13(1):56.
[11]	European Association for Study of Liver. EASL clinical practice guidelines: management of hepatitis C virus infection[J]. J Hepatol, 2014, 60(2): 392-420.
[12]	田玉岭, 赵伟, 沈玲, 等.聚乙二醇干扰素α-2a对乙型肝炎病毒复制及肝纤维化指标的影响[J].中华传染病杂志,2007,25(9):553-557.
[13]	GU S, LIU J, ZHANG H, et al.Core antigen tests for hepatitis C virus: a meta-analysis[J]. Mol Biol Rep, 2012, 39(8): 8197-8208.

组别	例数	HCV载量 (lg HCV RNA 拷贝/mL)	ALT(U/L)		AST (U/L)		HA (ng/mL)	LN (ng/mL)
Ⅰ组	23
第0周		5.8±0.3	80	±20	83	±6	150.3±60.3	80.3±10.8
第12周		2.9±0.0^**	40	±8^*	46	±3^*	90.1±18.3^*	60.1±15.9^*
第24周		2.9±0.0^**	28	±6^*	23	±8^*	50.1±10.2^*	30.2±8.1^*
第48周		2.9±0.0^**	16	±3^**	11	±4^**	27.2±2.6^**	13.2±6.1^**
Ⅱ组	17
第0周		6.3±1.3^△	150	±31^△	180	±20^△	220.1±80.3^△	100.5±20.3^△
第12周		3.6±1.6^*#	63	±12^*#	70	±6^*#	120.2±60.1^*#	70.9±10.5^*#
第24周		2.9±0.1^**#	45	±6^**#	48	±6^**#	92.1±20.1^*#	60.3±10.8^*#
第48周		3.0±0.3^**#	43	±9^**##	41	±5^**##	88.5±20.6^**##	40.8±8.7^**##

组别	例数	HCV载量 (lg HCV RNA 拷贝/mL)	ALT(U/L)		AST (U/L)		HA (ng/mL)	LN (ng/mL)
Ⅰ组	23
第0周		5.8±0.3	80	±20	83	±6	150.3±60.3	80.3±10.8
第12周		2.9±0.0^**	40	±8^*	46	±3^*	90.1±18.3^*	60.1±15.9^*
第24周		2.9±0.0^**	28	±6^*	23	±8^*	50.1±10.2^*	30.2±8.1^*
第48周		2.9±0.0^**	16	±3^**	11	±4^**	27.2±2.6^**	13.2±6.1^**
Ⅱ组	17
第0周		6.3±1.3^△	150	±31^△	180	±20^△	220.1±80.3^△	100.5±20.3^△
第12周		3.6±1.6^*#	63	±12^*#	70	±6^*#	120.2±60.1^*#	70.9±10.5^*#
第24周		2.9±0.1^**#	45	±6^**#	48	±6^**#	92.1±20.1^*#	60.3±10.8^*#
第48周		3.0±0.3^**#	43	±9^**##	41	±5^**##	88.5±20.6^**##	40.8±8.7^**##

组别	例数	EVR率	ETVR率	SVR率	复发率
Ⅰ组	23	100.0(23)	100.0(23)	100.0(23)	0.0(0)
Ⅱ组	17	52.9(9)^*	88.2(15)^*	76.5(13)^*	11.8(2)^**

组别	例数	EVR率	ETVR率	SVR率	复发率
Ⅰ组	23	100.0(23)	100.0(23)	100.0(23)	0.0(0)
Ⅱ组	17	52.9(9)^*	88.2(15)^*	76.5(13)^*	11.8(2)^**

组别	例数	BR率	HA复常率	LN复常率
Ⅰ组	23
第0周		0.0(0)	0.0(0)	0.0(0)
第12周		95.7(22)^*	91.3(21)^*	91.3(21)^*
第24周		100.0(23)^*	100.0(23)^*	100.0(23)^*
第48周		100.0(23)^*	100.0(23)^*	100.0(23)^*
Ⅱ组	17
第0周		0.0(0)	0.0(0)	0.0(0)
第12周		47.1(8)^*#	52.9(9)^*#	47.1(8)^*#
第24周		82.4(14)^*#	70.5(12)^*#	76.5(13)^*#
第48周		88.2(15)^*#	82.4(14)^*#	70.5(12)^*#