干擾素和RIBAVIRIN對慢性C型肝炎患者的療效預測指標分析–中台灣某醫院的回顧性研究

Predictive Factors for Therapeutic Effect of Interferon Alfa-2b and Ribavirin Conbination Therapy on Chronic Hepatitis C: A Retrospective Analysis in a Mid-Taiwan Hospital

慢性C型肝炎患者的標準治療方式為干擾素和Ribavirin，但其臨床療效與預測指標仍待研究。本研究探討經過干擾素和Ribavirin的治療後，持續性病毒反應（Sustain virus response）是否與性別、年齡、肝功能（ALT）數值有關。自1999年至2002年止，本院慢性C型肝炎患者未曾接受干擾素治療者，計有84人完成接受inter feron alfa-2b 三百萬單位和Ribavirin 1000mg治療，每週三次，為期24週。結果研究發現持續性病毒反應（SVR）為40.5%，SVR組（共計34人）比較Non-SVR組（計50人）中：（1）HCV RNA PCR < 2 x 106 copies/ml SVR組計26人（76.5%），Non-SVR組計24人（48%）。（2）年齡小於40歲者SVR組計10人（29.4%），Non-SVR組計2人（4%）。（3）性別：女性佔全組人數比例，SVR組計15人（44.1%），Non-SVR組計14人（38.9%）。（4）肝功能（ALT>120 U/L）數值，SVR組計13人（38.2%），Non-SVR組計27人（54%）。依統計分析HCV RNA PCR < 2 x 106copies/ml、年齡小於40歲有關，但與性別、肝功能（ALT>120 U/L）數值無關。結論：慢性C型肝炎患者，經過干擾素和Ribavirin的作用後，SVR預測指標為低濃度HCV-RNA濃度與年齡小於40歲。

Interferon–based therapy with ribavirin has become the standard treatment for patient with chronic hepatitis C. The sustained virus response (SVR) rate was reported to be approximately 40 % for previously untreated patients with chronic hepatitis C. From 1999 to 2002, 84 patients with chronic hepatitis C completed the interferon alfa-2b and ribavirin therapy for 24 weeks in our hospital. We retrospectively analyzed the percentage of SVR, and further investigated the predictive factors for SVR including age, sex, pretreatment virus load and alanine aminotransferase quotient. The results revealed that, the SVR rate was 40.5%. The SVR group had more frequency than non-SVR group in HCV- RNA level less than 2 x 106 copies/ml and age less than 40 years old. These results suggested that low virus load and younger age may be the important factors to predict the therapeutic effect of interferon and ribavirin in treating chronic hepatitis C.