研究動機:使用長效型干擾素以及雷巴威林是目前治療慢性C型肝炎的最新方式。雖然有其療效,但是這樣的治療方式有時卻伴隨著一些副作用而使得醫囑遵從性降低,也使得治療早期終止。到目前為止,並沒有任何已經發表的文獻著眼在哪些次族群跟治療的早期終止有關。因此我們設計了一個回溯性的研究來探討此主題。
材料方法:自2003年起至2012年為止。總共蒐集了約417位年齡大於50歲的慢性C型肝炎患者接受長效型干擾素a-2b合併雷巴威林治療的。病患的平均年齡為63.1歲(範圍為50-80歲),而HCV RNA病毒量平均是2.57 ± 4.79 ×106 IU/mL。按照健保給付B.C.肝試辦計劃規定必須由合格的消化系內科專科醫師治療且上網登錄治療情形。符合條件的對象是以前未參加過B.C.肝健保登錄的及未經治療過的台灣慢性C型肝炎患者。受試者在治療24週後,要持續追蹤24週後才算治療結束。回溯性的研究統計出在高齡層患者對於接受治療跟治療的早期終止相關因素分析。
結果:年老(大於70歲者)和肝硬化是主要因素,但若遵循醫囑性並可完成治療準則中的80/80/80規則,仍然可以提高SVR的。
Aims:The major recent advance in CHC treatment has been the invention of combination therapy with pegylated IFN plus ribavirin. Despite the efficacy, it is sometimes accompanied by side effects that may lead to compromised medical adherence and early termination of therapy. To date, there has not been any published research focusing on which subpopulations are linked to premature withdrawal of therapy.
Materials and Methods:We designed this retrospective study to investigate this issue. A total of 417 consecutive age over 50 y/o’ CHC patients who treated with pegylated IFN α-2b plus ribavirin were enrolled. The mean age was 63.1y/o (range: 50-80) and the mean HCV RNA level was 2.57 ± 4.79 ×106 IU/mL。According to NHI pilot scheme provides medical treatment by a specialist hospital in the digestive system. The object is to meet the conditions of chronic hepatitis C in Taiwan previously untreated patients. Subjects after 24 weeks of treatment, the treatment should be considered to keep track of the end of 24 weeks. A retrospective study of statistics in elderly patients layer treated with therapy for early termination of factors related。
Conclusion:Overall treatment respone of Elderly (over 70 years of age) and liver cirrhosis is the major factor, but if follow the doctor's orders and dose adherence 80/80/80 rule ,it’s still can improve the SVR。