摘要
目的:探讨HIV患者共感染难治性丙型肝炎病毒(HCV,基因1型和4型)后的临床药物处理对策。方法:收集国内外2000年至今报道的干扰素或聚乙二醇干扰素联合利巴韦林治疗HCV/HIV共感染患者的随机临床对照试验结果,提取其中共感染基因1型或4型HCV的HIV患者资料。利用Meta分析方法探讨HIV患者罹患丙型肝炎后,尤其是感染基因1型或4型HCV后的治疗方案。结果:Medline文献检索结果命中88篇文献,其中6篇符合纳入标准,共提取感染基因1型或4型HCV的HIV患者资料1 131份。数据分析结果显示,聚乙二醇干扰素联合利巴韦林治疗基因1型或4型HCV的HIV患者所获得的持续病毒反应率是26%,高于干扰素联合利巴韦林治疗的反应率(8%)。聚乙二醇干扰素联合利巴韦林治疗也优于聚乙二醇干扰素单独疗法(26%vs 13%)。而聚乙二醇干扰素联合利巴韦林疗法在基因2型或3型HCV感染的HIV患者可获得55%的持续病毒反应率。干扰素或聚乙二醇干扰素联合利巴韦林治疗HCV/HIV共感染患者的副反应发生率和停药率相似。结论:聚乙二醇干扰素联合利巴韦林在治疗基因1型或4型HCV的HIV患者时优于干扰素联合利巴韦林或聚乙二醇干扰素单独疗法。
Objective： To perform a Meta-analysis on peginterferon with interferon in treatment of HIV patients coinfected with refractory genetype HCV. Methods： A literature search of Medline was conducted to identify eligible randomized controlled trials. Meta analysis was conducted to evaluate peginterferon and interferon in treatment of coinfected HCV genotype 1 or 4 in HIV patients. Results： Six trials of 88 matched the selection criteria. Total 1 131 patients with coinfection of HCV genotype 1 or 4 and HIV were included. Sustain viral response was higher in patients treated with peginterferon plus ribavirin compared with that of interferon plus ribavirin （26% vs 8%） or peginterferon alone （26% vs 13%）. Severe adverse effects and withdrawal rates were similar for patients treated with peginterferon and patients treated with interferon. Conclusion： Peginterferon plus ribavirin in treatment of patients with coinfection of genotype 1 or 4 HCV and HIV can achieve higher sustain viral response and the likelihoods of serious adverse effects and withdrawal rates are similar to other therapies.
出处
《浙江大学学报（医学版）》
CAS
CSCD
北大核心
2009年第3期315-319,共5页
Journal of Zhejiang University(Medical Sciences)
基金
国家自然科学基金资助项目(30470089)
