Efficacy of peginterferonα-2a plus ribavirin for the treatment of patients with hepatitis B virus and hepatitis C virus coinfection:a paired study / 中华传染病杂志

ABSTRACT

Objective To analyze the virologic responses of peginterferonα‐2a plus ribavirin (Peg IFNα‐2a/RBV) for patients with hepatitis B virus (HBV) and hepatitis C virus (HCV) coinfection by a paired study . Methods Sixteen patients with HBV/HCV coinfection and 32 patients with HCV monoinfection were allocated . The virological response and biochemical response were compared between the two groups after Peg IFNα‐2a/RBV regimen treatment .Chi‐square analysis or Fisher exact analysis was used to compare the responses .Logistic analysis was conducted to evaluate factors associated with sustained virological response (SVR) .Results The median levels of HCV RNA were 6 .54 lg IU/mL in 16 patients with HBV/HCV co‐infection and 6 .98 lg IU/mL in 32 patients of HCV monoinfection ,which was statistically different (Z= 4 .124 , P0 .05) .The relapse rate in HBV/HCV‐coinfected patients was significantly higher than that in HCV‐monoinfected patients (35 .7% [5/16] vs 8 .7% [2/32];χ2=4 .142 , P= 0 .042) .In HBV/HCV coinfection group ,7 cases were HBV DNA detectable ,7 cases were hepatitis B e antigen (HBeAg ) positive , 13 cases were abnormal alanine aminotransferase (ALT) levels and 12 cases were abnormal aspartate aminotransferase (AST ) levels . After treatment ,only 4 patients were HBV DNA detectable ,5 cases were HBeAg positive ,4 cases were abnormal ALT levels and 5 cases were abnormal AST levels (P= 0 .458 ,0 .716 ,0 .004 and 0 .032 , respectively) .The median level of hepatitis B surface antigen (HBsAg) was 780 IU/mL and decreased to 250 IU/mL after treatment ,while the difference did not reach statistical significance (Z= 1 .826 ,P=0 .068) .A total of 4 patients achieved complete virologic response for HBV ,3 achieved partial virologic response;2 achieved HBeAg seroconversion .Logistic regression analysis showed that EVR was a positive factor for achieving SVR (OR=35 .2 ,95% CI=3 .55-349 .15 , P=0 .002) .Conclusions HCV remains at low replication level in patients with HBV/HCV coinfection .Virological responses can be achieved by Peg IFNα‐2a/RBV treatment .EVR might be a positive factor associated with SVR .