Alpha IFN和Ribavirin联用治疗HBV和HCV双重感染的病毒交感和反应（2005.3.19）

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Antivir Ther. 2005;10(1):125-33.

Viral interaction and responses in chronic hepatitis C and B coinfected
patients with interferon-alpha plus ribavirin combination therapy.

Chuang WL, Dai CY, Chang WY, Lee LP, Lin ZY, Chen SC, Hsieh MY, Wang LY, Yu
ML.

Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical
University, Kaohsiung, Taiwan.

BACKGROUND/AIMS: We conducted a case-control study to investigate the
efficacy of interferon-alpha (IFN-alpha) and ribavirin combination therapy
for patients with chronic hepatitis C and B virus (HCV/HBV) coinfection and
to elucidate the interaction of these two viruses. METHODS: Forty-two
chronic HCV/HBV-coinfected patients (29 IFN-naive, 13 IFN-relapsed) and 84
HCV-monoinfected controls, matched for age, sex and previous history of
IFN-alpha therapy, were enrolled. All patients were treated with
IFN-alpha-2b 6 MU three-times weekly plus ribavirin 1000-1200 mg daily for
24 weeks. Serum HCV RNA and HBV DNA were determined every 24 weeks for 72
weeks. RESULTS: The rate of HCV sustained virological response (SVR) was
comparable among IFN-naive and IFN-relapsed HCV/HBV-coinfected patients and
IFN-naive and IFN-relapsed HCV-monoinfected patients (69.0%, 69.2%, 67.2%
and 57.7%, respectively; intention-to-treat analysis). HCV genotype 1b, high
pretreatment HCV RNA levels and liver fibrosis were significantly associated
with a lower HCV SVR. Of 16 baseline HBV viraemic patients, five (31.3%)
achieved HBV SVR, which correlated negatively to HCV genotype non-1b and HCV
SVR. Only one (6.3%) had simultaneous seroclearance of HCV and HBV.
Antibodies to HBV surface antigen seroconversion developed in five (11.9%)
patients during long-term follow-up. HCV responders had significantly higher
rates of HBV DNA resurgence than HCV non-responders during and after
treatment. Reciprocal viral interference was noted between HCV and HBV after
IFN-alpha/ribavirin therapy. CONCLUSIONS: IFN-alpha/ribavirin combination
therapy is effective for HCV/HBV-coinfected patients in eradicating HCV
infection and might promote HBV seroclearance, and there is a mutual viral
response and reciprocal viral interaction between HBV and HCV.

PMID: 15751770 [PubMed - in process]