Treatment of hepatitis C virus infection

Acute and chronic hepatitis C virus （HCV） infection remains a serious health problem worldwide, however, there has been advancement in the treatment of HCV infection due to standard treatment using pegylated interferon and ribavirin. The literature indicates that therapy for HCV is becoming more individualized. In addition to considering genotype and viral RNA levels before treatment, achievement of an early virologic response （EVR） and a rapid virologic response （RVR） is now possible during therapy. Moreover, problem patients, such as non-responders, relapsers, HIV or HBV coinfected patients, patients with liver cirrhosis, and preor post-liver transplantation patients are an increasing fraction of the patients requiring treatment. This article reviews the literature regarding standard treatments and problem patients with acute and chronic HCV infection. It also includes discussion on contraindications and side effects of treatment with interferon and ribavirin, as well as new drug development.     

利巴韦林联合炎琥宁治疗手足口病60例疗效观察

目的：观察利巴韦林联合炎琥宁治疗手足口病的疗效。方法：将60例手足口病患儿分为两组,对照组用利巴韦林治疗,治疗组用利巴韦林加炎琥宁。结果：两组有效率经χ2检验,P〈0.05,差异有显著性,治疗组有效率高于对照组。结论：利巴韦林联合炎琥宁治疗手足口病有明显效果,且炎琥宁为中成药,不良反应少,值得推荐。     

A randomized study on Peg-interferon alfa-2a with or without ribavirin in liver transplant recipients with recurrent hepatitis C

BACKGROUND/AIMS: We performed a randomized trial on pegylated interferon alfa-2a (Peg-IFNalpha) monotherapy vs Peg-IFNalpha and ribavirin in non-cirrhotic liver transplant recipients with recurrent hepatitis C. METHODS: Forty-two patients transplanted for HCV-related cirrhosis 12-96 months earlier were randomized to Peg-IFNalpha monotherapy (180 microg weekly) or Peg-IFNalpha and ribavirin, up to the maximum tolerated dose, for 48 weeks. RESULTS: Early virological response (EVR, i.e., HCV-RNA2 log drop at week 12) occurred in 76% of the monotherapy and 71% of the combination groups, respectively (intention-to treat). Sustained virological response (SVR) occurred in 8 (38%) and 7 (33%) patients, respectively. EVR had a positive predictive value for SVR of 50% and 47%, respectively, and a 100% negative predictive value in both groups. Six drop-outs occurred in the monotherapy (including 3 rejections) and 7 in the combination groups (including one rejection). Peg-INFalpha dose was reduced in 7 and 8 patients, respectively. The average daily dose of ribavirin was 435 mg/day. CONCLUSIONS: Peg-IFNalpha-2a, with or without ribavirin, induces SVR in one-third of transplant recipients with recurrent hepatitis C. Treatment cessation is indicated in patients without EVR. The low SVR rate is mainly due to inability to sustain full doses of antivirals and lack of the booster effect of ribavirin.     

Inhibition of bovine viral diarrhea virus in vitro by xanthohumol: Comparisons with ribavirin and interferon-α and implications for the development of anti-hepatitis C virus agents

Xanthohumol (XN) is a natural compound with potential antiviral activity. In this study, the ability of XN to inhibit bovine viral diarrhea virus (BVDV), a surrogate model of hepatitis C virus (HCV), was investigated. The antiviral activity of XN was compared with that of ribavirin (RBV) and interferon (IFN)-α. The results showed that XN could inhibit BVDV induced cytopathic effects (CPE). At 1000 TCID₅₀ and 100 TCID₅₀, the values of 50% effective concentration (EC₅₀) were 3.24 ± 0.02 mg/l and 2.77 ± 0.19 mg/l, respectively, and the therapeutic indices were >7.72 and >9.03, respectively. XN inhibited BVDV E2 expression and viral RNA levels in a dose-dependent manner. At 6.25 mg/l, XN decreased the viral RNA from released virus by 3.83 log 10 at 1000 TCID₅₀ and to an undetectable level at 100 TCID₅₀, and decreased the viral RNA level in whole cell culture by 3.36 log 10 and 2.88 log 10 at 1000 TCID₅₀ and 100 TCID₅₀, respectively. The inhibitory activity of XN on CPE, BVDV E2 expression and viral RNA levels was stronger than that of RBV and weaker than that of IFN-α. These results indicate the need to investigate the anti-HCV potential of XN.     

炎琥宁治疗疱疹性咽峡炎110例疗效观察

目的探讨炎琥宁对疱疹性咽峡炎的疗效。方法将2007—2008年门诊观察治疗的疱疹性咽峡炎患儿110例随机分为2组,治疗组60例给予炎琥宁冻干粉剂（10—15rag·kg^-1·d^-1）静脉滴注或肌内注射;对照组50例给予利巴韦林（10—15mg·kg^-1·d^-1）静脉滴注,疗程3—5d,并根据病情给予相应的对症支持治疗,在退热时间、临床症状改善方面做综合性疗效比较。结果治疗组总有效率为93．3％,对照组为78．O％,2组比较差异有统计学意义（P〈0．01）。结论炎琥宁治疗疱疹性咽峡炎疗效好、病程短,可作为疱疹性咽峡炎的首选药物。     

综合疗法治疗小儿疱疹性口炎临床观察

目的：观察健康宣教、家庭护理及中西医结合综合治疗小儿疱疹性口炎的临床疗效。方法：将笔者所在科室2012年2月-11月诊断为疱疹性口炎的120例患儿随机分为治疗组和对照组,各60例,对照组予以利巴韦林气雾剂局部应用,治疗组在对照组治疗基础上予健康宣教、家庭护理及口服口炎清颗粒治疗,观察两组疗效。结果：治疗组总有效率95%,对照组总有效率78%,治疗组疗效优于对照组,差异有统计学意义（P〈0.05）;两组症状、体征消失时间相比,观察症状、体征消失时间明显短于对照组,差异具有统计学意义（P〈0.05）。两组患者在治疗过程中均未见不良反应。结论：综合疗法治疗小儿疱疹性口炎见效快,疗程短,值得临床推广。     

利巴韦林在单纯疱疹病毒性脑炎治疗中的应用效果观察

目的观察利巴韦林对单纯疱疹病毒性脑炎患儿的治疗效果,为该治疗方案的推广使用积累临床经验。方法选取中国人民解放军联勤保障部队第九二四医院2018年1月—2019年11月收治的80例单纯疱疹病毒性脑炎患儿为研究对象,按照随机数余数分组法均分为两组,每组各40例,分别采用更昔洛韦(10~30 mg/kg静脉滴注,3次/d,给药14 d)和利巴韦林(10~15 mg/kg静脉滴注,2次/d,给药14 d)进行治疗并对两组疗效进行对比。结果利巴韦林组总有效率(92.50%,37/40)高于更昔洛韦组(80.00%,32/40),差异有统计学意义(χ²=6.588,P=0.010);两组不良反应发生率分别为7.50%(3/40)和10.00%(4/40),差异无统计学意义。治疗后利巴韦林组和更昔洛韦组比较,C反应蛋白[(15.80±5.25)mg/L vs(20.42±5.38)mg/L]、白细胞介素-6[(10.24±2.75) ng/L vs(17.89±2.81)ng/L]、肿瘤坏死因子-α[(35.70±9.80) ng/L vs(50.31±9.77)ng/L]、血清神经元特异性烯醇酶[(9.77±1.33)μg/L vs(12.24±1.46)μg/L]和脑脊液神经元特异性烯醇酶[(10.25±1.96)μg/L vs(14.11±1.89)μg/L]在利巴韦林组均低于更昔洛韦组,差异有统计学意义(P均<0.001),利巴韦林组发热消失时间[(3.10±0.35)d vs(4.60±0.40)d]、头痛/呕吐消失时间[(2.25±0.25)d vs(3.10±0.20)d]、抽搐消失时间[(2.20±0.20)d vs(3.35±0.30)d]、意识障碍消失时间[(4.30±0.50)d vs(6.40±0.55)d]均短于更昔洛韦组,差异有统计学意义(P均<0.001)。结论利巴韦林治疗单纯疱疹病毒性脑炎效果确切、不良反应发生率低,值得推广。     

流行性角结膜炎治疗的患者舒适度及病程调查

目的 总结出流行性角结膜炎舒适、缩短病程的治疗方法,供大家借鉴与参考（探讨流行性角结膜炎不同治疗方法疗效,为临床治疗方法的选择提供科学依据）。方法120例流行性角结膜炎患者,随机分为3组,分别接受三种不同的治疗方法,彼此对照,分析其临床意义。结果 接受干扰素配成眼药水治疗组,患者普遍感到舒适,但不缩短病程;接受阿昔洛韦眼药水、利巴韦林眼药水及微量地塞米松注射液混合制剂点眼组,患者感到病情明显好转,大多数用药3d痊愈,缩短病程;而接受阿昔洛韦眼药水治疗组,患者仍然感到疾病痛苦,病程并不缩短。结论流行性角结膜炎患者接受干扰素配成眼药水治疗会感到疾病痛苦明显减轻,明显改善症状,但不缩短病程;阿昔洛韦眼药水、利巴韦林眼药水及微量地塞米松配成混合制剂点眼,患者感到明显好转,缩短病程,受到患者欢迎,两种方法均优于阿昔洛韦眼药水点眼治疗,是治疗流行性角结膜炎的良好方法。     

双黄连雾化吸入治疗喘憋性肺炎疗效观察

目的 :探讨双黄连针剂雾化吸入对喘憋性肺炎的疗效。方法 :双黄莲针剂用生理盐水稀释到 2 0mg/ml雾化吸入 ,并与病毒唑雾化吸入比较。结果 :双黄连与病毒唑雾化吸入治疗喘憋性肺炎疗效无显著性差异。结论 :双黄莲雾化吸入治疗喘憋性肺炎是安全、有效的方法 ,可替代病毒唑进行雾化吸入。