干扰素对HIV／HCV合并感染者抗HCV早期疗效观察

目的通过分析HIV/HCV合并感染者使用长效/普通干扰素联合利巴韦林抗HCV早期治疗效果,探讨更适合我国国情的HIV/HCV合并感染的抗HCV治疗方案。方法 129例经HAART治疗的HIV/HCV合并感染者随机选用PEG-IFN-α-2a或IFN-α-2b联合利巴韦林治疗,利用巢氏PCR加测序分析检测HCV基因分型,COBASTM全自动病毒载量分析系统分别检测抗HCV治疗前、治疗后4周、12周的外周血HCVRNA载量,获得HIV/HCV合并感染者抗HCV快速病毒学应答率（RVR）、早期病毒学应答率（EVR）。结果我国HIV/HCV合并感染者中,HCV基因型为1型患者占34.0%,非1型者占66.0%。使用普通干扰素抗HCV治疗组RVR、EVR、cEVR与PEG干扰素组比较无显著差异;普通干扰素组中HCV非基因1型早期治疗效果优于HCV基因1型（P〈0.05）,PEG干扰素组HCV-1型和非1型早期治疗效果比较无显著差异;PEG及普通干扰素在抗HCV治疗过程中对患者肝功能的恢复均有积极效用（P〈0.05）。结论 PEG及普通干扰素联合利巴韦林抗HCV方案治疗我国HIV/HCV合并感染者均能取得较好的早期疗效。普通干扰素方案对HCV非基因1型HIV/HCV合并感染者中可获得良好的早期治疗效果。

Early effect of interferon on patients with HIV/HCV coinfection

Objective To investigate the suitable therapy of chronic hepatitis C virus（HCV）and human immunodeficiency virus（HIV）coinfection patients in China,through evaluating the early efficacy of common interferon α-2b（IFN）plus ribavirin（RBV）treatment versus peg-interferon α-2a（PEG-INF）plus RBV treatment.Methods Treatment of IFN plus RBV or PEG-INF plus RBV were received by patients with HCV/HIV coinfection（129 cases）after HAART.HCV genotypes were identified,and HCV RNA load,alanine aminotransferase（ALT）,aspartate aminotransferase（AST）of patients were analyzed at different times during treatment（0,2nd,4th and 12th week）,respectively.Rapid virological response（RVR）at 4th week and early virological response（EVR）at 12th week were assessed to predict sustained virological response（SVR）.Results The percentage of non-genotype-1 HCV infection in HIV/HCV coinfected patients was 66.0%,and genotype 1 HCV infected patients account for 34.0%.There were no significant difference of RVR,EVR and cEVR between IFN plus RBV group and PEG-INF plus RBV group.In IFN plus RBV group,patients of HCV genotype 1 had significant lower EVR and cEVR compared to patients infected with other HCV genotypes（P〈 0.05）.The levels of ALT and AST decreased after effective treatment of IFN plus RBV or PEG-INF plus RBV.Conclusions The early effects of IFN plus RBV and PEG-INF plus RBV treatment are both significant in patients with HIV/HCV coinfection.Treatment of IFN plus RBV is more effective for non-genotype-1 HCV infection than genotype 1 HCV infection in patients with HIV/HCV coinfection.