Efficacy of combination therapy with pegylated-interferon alfa-2a plus ribavirin in autoantibody-positive chronic hepatitis C patients.
10.3760/cma.j.issn.1007-3418.2013.05.008
- VernacularTitle:聚乙二醇干扰素α-2a联合利巴韦林治疗自身免疫抗体阳性慢性丙型肝炎的临床疗效
- Author:
Ya-xin LI
1
;
Yan-jia YANG
;
Mei YANG
;
Li-yu CHEN
;
Jia-jie LU
;
Yuan-ji MA
;
Kai LIU
;
Xue-zhong LEI
;
Hong TANG
Author Information
1. West China Hospital, Sichuan University, Chengdu, China.
- Publication Type:Clinical Trial
- MeSH:
Adult;
Antiviral Agents;
therapeutic use;
Autoantibodies;
blood;
Drug Therapy, Combination;
Female;
Hepatitis C, Chronic;
blood;
drug therapy;
Humans;
Interferon-alpha;
therapeutic use;
Male;
Polyethylene Glycols;
therapeutic use;
Recombinant Proteins;
therapeutic use;
Ribavirin;
therapeutic use;
Treatment Outcome
- From:
Chinese Journal of Hepatology
2013;21(5):345-347
- CountryChina
- Language:Chinese
-
Abstract:
To evaluate the therapeutic efficacy of antiviral combination therapy with pegylated-interferon alpha-2a plus ribavirin (RBV) in patients with autoantibody-positive chronic hepatitis C (CHC) and to investigate the impact of the presence of autoantibodies on the treatment outcome. Eighty-six consecutive CHC patients who underwent a 48-week treatment regimen composed of Peg-IFNa-2a (135 or 180 mug/wk) plus weight-based RBV ( less than or equal to 65 kg, 800 mg/d; 65 to 75 kg, 1000 mg/d; more than or equal to75 kg, 1200 mg/d ). Prior to treatment (baseline) and at end of treatment (EOT; week 48), levels of antinuclear antibody (ANA), anti-smooth muscle antibody (SMA), anti liver/kidney microsomal antibody type 1 (LKM1), anti-La (SSB), and anti liver cytosolic-1 (LC-1) were detected by indirect immunofluorescence. At baseline, during treatment (weeks 4, 12, 24, and 36), EOT, and 24 weeks after EOT, levels of HCV RNA were assessed by real-time quantitative PCR. Rapid virological response (RVR) was defined as HCV RNA less than 10(3) copy/ml at week 4. Sustained virologic response (SVR) was defined as HCV RNA load below the lower limit of detection at 24 weeks after EOT. Correlation between autoantibodies and treatment-induced reduced HCV RNA load was assessed by univariate analysis of variance or chi-squared tests. Autoantibodies were detected in 24 patients, which included 14 ANA-positive patients, five SMA-positive patients, three LKM1-positive patients, one patient with double-positivity for ANA and SSB, and one patient with double-positivity for ANA and LC-1. The autoantibody-positive patients and autoantibody-negative patients showed similar rates of RVR (70.8% vs. 72.5%, P more than 0.05) and SVR (81.4% vs. 82.2%, P more than 0.05). Antiviral therapy with Peg-IFNa-2a RBV can effectively reduce the HCV RNA load in autoantibody-positive CHC patients; however, the presence of autoantibodies may not be an independent predictor of therapy outcome.
