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<p><b>OBJECTIVE</b>To perform a prospective,multicenter,open,randomized study to determine a treatment regimen for treatment-naive patients with refractory chronic hepatitis C (RHC) using the predictive value (PV) of early virological response (EVR).</p><p><b>METHODS</b>A total of 438 patients from 18 hospitals were recruited between December 2008 and December 2010 and administered peg-interferon/ribavirin treatment for 12 weeks. Patients who achieved complete EVR (cEVR) were assigned to group A for a 48-week course of treatment, while patients without cEVR were randomly allocated to either group B 1 for a 72-week course of treatment or to group B2 for a 96-week course of treatment. Serum hepatitis C virus RNA levels at baseline,treatment weeks 4, 12 and 24, end of treatment, and post-treatment week 24 were measured and used to evaluate the efficiency of therapy.</p><p><b>RESULTS</b>The overall sustained virological response (SVR) rate was 85.1%. In all, 91.0% of patients achieved cEVR and were assigned to group A, which had an SVR rate of 90.8%. There was no statistically significant difference in the SVR rates of groups B1 and B2 (29.4% vs. 25.0%, P more than 0.05). The positive PV of rapid virological response (RVR), cEVR and delayed virological response (DVR) for SVR was 93.4%, 90.8% and 77.8% respectively, and the negative PV of RVR, EVR and DVR for SVR was 28.0%, 93.3% and 100% respectively. Overall, 66.9% of the patients experienced adverse events (AEs), but only 1.9% of patients experienced sevcre AEs.</p><p><b>CONCLUSION</b>The majority of Chinese RHC treatmentna(i)ve patients (91.0%) can achieve cEVR and a high SVR rate with a low rate of severe AEs using the cEVR guided personal treatment regimen.</p>
Subject(s)
Humans , Antiviral Agents , Asian People , Drug Therapy, Combination , Hepatitis C, Chronic , RibavirinABSTRACT
TCM hospital preparation, which is only used inside its own orgnations, is an important part of clinical medicine in TCM. In recent years, the lack of a corresponding constitution of legal safeguard seriously hampered the prosperities of TCM hospital preparations. It's a high time to settle a targeted legal safeguard constitution of TCM preparations developed by the hospital. The author takes hospital of TCM preparation as the research object, starting from the current situation and problems of development of hospital of TCM to dig out the reasons. It has great significance to ensure the status of TCM preparation developed by the hospital at first, to combine with other measures. and to put forward about the establishment of comprehensive legal safeguard mechanism for the development TCM hospital preparation.
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Objective To evaluate the efficacy of pegylated interferon ( PegIFN ) α-2a plus ribavirin ( RBV) therapy for chronic hepatitis C ( CHC) in non-responders, and to investigate the related influencing factors.Methods A prospective, open, multicenter and randomized study was conducted.A total of 81 CHC non-responders were recruited from 10 clinical centers during February 2009 to November 2011.Patients were randomly assigned into two groups:group A (n=37) was given PegIFNα-2a plus RBV treatment for 72 weeks and group B (n=44) was given PegIFNα-2a plus RBV treatment for 96 weeks.Both groups were followed up for 24 weeks after treatment.Virological responses in two groups were observed, and treatment efficacies among patients with different genotypes, and among those with different previous treatment were compared.SAS software was used for statistical analysis.Results Fifty-two patients ( 28 from group A and 24 from group B) completed the study in total.The rates of rapid virological response ( RVR) , complete early virological response ( cEVR ) , end of treatment viral response ( ETVR ) and sustained virological response (SVR) in group A were 25.0% (7/28), 60.7% (17/28), 67.9%(19/28) and 60.7%(17/28), respectively; while those in the group B were 41.7% (10/24), 70.8%(17/24), 70.8%(17/24) and 70.8% (17/24), respectively; and there were no significant differences between two groups (P>0.05).SVR was observed in 82.9%(29/35) of patients with CC genotype of IL-28B, which was higher than that in patients with other genotypes ( 3/13 ) , and the difference was of statistical significance (P0.05).The rates of RVR, cEVR, ETVR and SVR in patients who were previously treated with IFN were 36.4%(12/33), 81.8%(27/33), 81.8%(27/33) and 75.8%(25/33), and the rates of cEVR, ETVR and SVR were higher than those in patients who were previously treated with PegIFN (P0.05).Adverse events occurred in 38 patients (46.9%), but no severe ones were observed. Conclusion The efficacy of PegIFNα-2a plus RBV therapy for CHC in non-responders is satisfactory, which may influenced by IL-28B genotypes and previous treatment.
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Objective To analyze the inpatients species changes of infectious disease hospital from 2001 to 2011 years in Taiyuan,and make relevant recommendations to the trends and prevention strategies for common infectious diseases.Methods The diseases species of the hospital from 2001 to 2011 years and the number of hospitalized patients were retrospectively counted and analyzed.Results The proportion of liver disease hospitalized was always more than 60％ in the ten years;The bacillary dysentery decreased from 4.23％ in 2006 to 0.96％ in 2011 ;The hospitalized patients with measles decreased significantly since 2009,and only 0.26％ in 2011 ;In 2008,hand-foot-mouth disease accounted for 3.42％ of the hospitalized patients,and it peaked in 2010,accounting for 7.51％ ; The number of hospitalized patients with rabies disease rised in 2011,accounting for 0.27％.Conclusion Liver disease is still the major infectious diseases of the hospital;The mumps,chicken pox,scarlet fever and other respiratory diseases as well as hand-foot-mouth disease is a common infectious disease threats to the health of infants and young children,and for the increasing trend of the number of patients with brucellosis hairtetracycline,the tetracycline and brucellosis drugs for children should be promoted to product and sale.The rabies vaccination knowledge should be popularized,and the incidence of rabies should be reduced.