个体化治疗聚乙二醇干扰素α- 2b和利巴韦林为24-72周，提高

StephenW

Improved Responses to Pegylated Interferon alfa-2b and Ribavirin by Individualizing Treatment for 24-72 Weeks; 个体化治疗

聚乙二醇干扰素α- 2b和利巴韦林
为24-72周
，提高能力应对;

Sarrazin C, Schwendy S, Möller B, Dikopoulos N, Buggisch P, Encke J, Teuber G, Goeser T, Thimme R, Klinker H, Boecher WO, Schulte-Frohlinde E, Prinzing R, Herrmann E, Zeuzem S, Berg T; Gastroenterology (Jul 2011)
BACKGROUND&AIMS: Guidelines recommend that patients with chronic hepatitis C virus (HCV) infection be treated with pegylated interferon and ribavirin for 24, 48, or 72 weeks, based on their virologic response to treatment. We investigated the effects of treating patients for individualized durations. METHODS: We treated 398 treatment-naïve patients who HCV genotype-1 infections with pegylated interferon alfa-2b and ribavirin for 24, 30, 36, 42, 48, 60 or 72 weeks (mean 39 weeks, termed individualized therapy); the duration of therapy was determined based on baseline viral load and the timepoint at which HCV RNA became undetectable (measured at weeks 4, 6, 8, 12, 24, and 30). Results were compared to 225 patients who received standard treatment, for 48 weeks (mean of 38 weeks). RESULTS: Rates of sustained virologic response (SVR) were 55% among patients that received individualized treatment and 48% among those that received standard treatment (P<.0001 for non-inferiority). SVR rates, according to the timepoint at which HCV RNA became undetectable, did not differ significantly between groups. Patients with a rapid virologic response (undetectable levels of HCV RNA at week 4) who were treated for 24-30 weeks achieved high rates of SVR (86%-88%). Rates of SVR increased among slow responders that first tested negative for HCV RNA at week 24 and were treated for 60-72 weeks, compared with those treated for 48 weeks (60%-68% vs 43%-44%). The CC polymorphism at IL28B rs129797860 was associated with an increased rate of SVR, compared with the CT/TT polymorphism (P<.0001), at baseline but not among patients who had undetectable levels of HCV RNA following treatment. CONCLUSIONS: Individualizing treatment of patients with chronic HCV genotype 1 infections for 24-72 weeks results in high rates of SVR among rapid responders and increases SVRs among slow responders.

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背景与目的：指南建议，24，48或72周，根据他们治疗的病毒学应答，与聚乙二醇干扰素和利巴韦林治疗慢性丙型肝炎病毒（HCV）感染患者。我们调查，治疗个性化的工期患者的影响。方法：我们收治398治疗初治患者HCV基因型1感染与聚乙二醇干扰素α- 2b和利巴韦林24，30，36，42，48，60或72周（平均39周，称为个体化治疗），持续时间治疗基线病毒载量和丙型肝炎病毒RNA成为检测不到（在4周，6，8，12，24和30测量）的时间点的基础上确定。收到48周（平均38周）的标准治疗，225例患者进行了比较，结果。结果：持续病毒学应答（SVR）率分别为55％的患者接受个体化治疗，在那些接受标准治疗的48％，非劣效性（P <0.0001）。根据SVR率，丙型肝炎病毒RNA成为检测不到的时间点，没有明显不同群体之间。快速病毒学应答（丙型肝炎病毒RNA检测不到的水平，在4周）24-30周治疗的患者达到高的SVR率（86％-88％）。 SVR率上升缓慢应答之间的第一次检测结果呈阴性丙型肝炎病毒RNA在24周和60-72周的治疗，与治疗48周（60％-68％和43％-44％）相比。 IL28B rs129797860 CC多态性相关的SVR率增加的CT / TT多态性（P <0.0001），在基线，但不属于患者丙型肝炎病毒RNA治疗后检测不到的水平相比。结论：个体化治疗慢性丙型肝炎病毒基因1型感染为24-72周之间缓慢响应之间的快速反应和增加SVRS的SVR率很高的结果。