关键词: 慢性丙性肝炎, HCV 基因型, 聚乙二醇化干扰素-α, 利巴韦林, 疗效

Abstract: Objective To compare the therapeutic efficacy of pegylated interferon-α （peg-IFN-α） in treatment of patients with different hepatitis C viral genotype infection. Methods 108 patients with chronic hepatitis C（CHC）,including 58 with hepatitis C virus（HCV） genotype one,and 50 with non-genotype one infection,were recruited in our hospital between October 2013 and October 2016,and all patients were treated with combination of peg-IFN-α and ribavirin for 48 weeks. All patients were followed-up for 24 weeks. The virological and biochemical responses were compared between the two groups. Results At baseline,the age,gender,body mass index,serum ALT and HCV RNA levels in the two groups were not significantly different（P>0.05）;the rapid virological response（RVR）,early virological （EVR）,end treatment virological response （ETVR） and sustained virological response rates in patients with non-genotype one infection were 74.0%,82.0%,88.0% and 86.0%,all significantly higher than 51.7%,60.3%,63.8% and 58.6%,P<0.05） in patients with HCV genotype one infection;the SVR in 67 patients having RVR was 100.00%,much higher than 25.6% （P<0.05） in 41 patients without,and the SVR in 76 patients having EVR was 94.7%,also much higher than 15.6% （P<0.05） in 32 patients without;in patients with serum HCV RNA levels less than or equal to 4×10⁵ IU/ml,the virologic response rates in patients with HCV genotype I or non-genotype I infection were not significantly different（P>0.05）,while in those with serum HCV RNA greater than 4×10⁵ IU/ml, the RVR,EVR,ETVR and SVR in 39 patients with non-genotype I infection were 71.8%,79.5%,87.2% and 84.6%,significantly higher than 50.0%,59.1%,63.6% and 74.4% （P<0.05） in 44 patients with HCV genotype I infection;at the end of 24 week,48 week of the treatment and 24 week of follow-up,the biochemical responses rates in patients with non-genotype I infection were 70.0%,80.0% and 84.0%,all significantly higher than 50.0%,60.3% and 69.0%（P<0.05）. Conclusion The standard combination of peg-interferon-α and ribavirin is effective in the treatment of patient with non-HCV type I infection,and an alternative therapy should be considered in patients with HCV type I infection,not getting RVR and EVR,and with high serum HCV loads.

Key words: Hepatitis C, HCV genotypes, Pegylated interferon-α, Ribavirin, Therapy