Efficacy of Peginterferon Alfa Plus Ribavirin Treatment for Chronic Hepatitis C Virus Infection in Cirrhotic Patients

合併長效型干擾素及RIBAVIRIN治療肝硬化患者之慢性C型肝炎的療效評估

林恭弘(Kung-Hung Lin) ； 許秉毅(Ping-I Hsu) ； 蔡維倫(Wei-Lun Tsai) ； 陳文誌(Wen-Chi Chen) ； 黎國洪(Kwok-Hung Lai) ； 余憲忠(Hsien-Chung Yu)

《安泰醫護雜誌》 17卷2期 (2011/06) Pp. 53-62

https://doi.org/10.7078/TSMHMNJN.201106.0055

摘要

腹直肌血腫是一種罕見引起急性腹痛的急症，目的：慢性C型肝炎所致肝硬化患者之預後不佳，每年約有5%發生肝失償。根除C型肝炎病毒可以避免這些患者之疾病惡化。本回溯性研究之目的在於探討肝硬化患者接受長效型α-干擾素加雷巴威林（ribavirin）治療慢性C型肝炎感染之效果，並比較此合併療法於肝硬化及非肝硬化患者之療效。方法：本研究將2003年9月至2009年11月間，接受長效型α-干擾素加雷巴威林治療慢性C型肝炎之肝硬化與非肝硬化患者納入，比較肝硬化與非肝硬化患者之基本特徵、病毒學反應、與不良作用之發生率。結果：本研究共納入15位肝硬化及121位非肝硬化，接受長效型α-干擾素加雷巴威林治療之患者。兩組患者治療前之病毒量、基因型、年紀、及性別皆近似。於治療過程中，肝硬化患者有快速病毒學反應之比率較非肝硬化組為低（57.1%與92.5%, P=0.035）。肝硬化組之治療終反應率及持續性病毒學反應率（分別為86.7%與60.0%）較非肝硬化組（89.8%與68.6%）略低，但兩者之差距皆未達統計學差異（P值分別為0.659與0.562）。此外，肝硬化組與非肝硬化組之不良作用發生頻率亦無明顯差別。結論：肝硬化及非肝硬化之C 型肝炎患者接受長效型α-干擾素加雷巴威林治療可以達到不錯的療效。

關鍵字

C型肝炎病毒 ； 長效型干擾素 ； 雷巴威林 ； 肝硬化

並列摘要

Objective: Hepatitis C virus (HCV)-related cirrhotic patients have a poor prognosis with 5% annual risk of hepatic decompensation. Eradicating HCV may prevent disease progression of cirrhotic patients. The aims of this retrospective study were to investigate the efficacy of peginterferon-α plus ribavirin treatment for chronic HCV infection in cirrhotic patients and to compare the efficacies of the combined therapy between patients with and without cirrhosis. Method: From September 2003 to November 2009, cirrhotic and non-cirrhotic HCV-infected patients receiving ribavirin plus peginterferon-α therapy were included. The baseline characteristics, virological response and incidence of adverse events were compared between the patients with and without cirrhosis. Results: Fifteen cirrhotic and 121 non-cirrhotic patients receiving ribavirin plus peginterferon-α therapy were included. The baseline HCV RNA levels, genotype, age, and gender were comparable between groups. Cirrhotic patients had a lower rapid virological response (RVR) rate than non-cirrhotic patients (57.1% vs. 92.5%, P=0.035). The end-of-treatment response (ETR) rate and sustained virological response (SVR) in cirrhotic patients (86.7% and 60.0%, respectively) were slightly lower than those in non-cirrhotic patients (89.8% and 68.6%) but both differences didn’t reach statistic significance (P = 0.659 and 0.562, respectively). Additionally, there were no significant differences in the frequencies of adverse events between cirrhotic and non-cirrhotic patients. Conclusions: Those cirrhotic patients who received standard treatment with ribavirin plus peginterferon-α might achieved an acceptable SVR rate in Taiwan.

並列關鍵字

HCV ； peginterferon-α ； ribavirin ； cirrhosis