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目的 对5 4例小儿慢性丙型肝炎(CHC)采用聚乙二醇α2a干扰素进行抗病毒治疗前瞻性研究。方法 以α干扰素1～3MIU诱导治疗后,聚乙二醇α2a干扰素剂量为每周10 4 μg m2 体表面积。利巴韦林剂量为15～2 0mg·kg 1 ·d 1 。结果 本组4 2 6 %CHC患儿经标准α干扰素联合利巴韦林治疗失败,70 8%患儿为HCVRNA基因Ⅰ型;14 8%患儿为高病毒载量。联合治疗3个月后87 5 %患儿HCVRNA阴转,8 3%HCVRNA下降≥2log。治疗6个月后87 9%HCVRNA阴转,6 1%HCVRNA下降≥2log。发生轻度流感样症状患儿为5 1 9% ,发热4 8 1% ,且多为低热。乏力4 6 3% ,食欲下降9 3% ,皮疹3 7%。患儿血中性粒细胞计数≤2 0×10 9 L为94 4 % ,其中<1 0×10 9 L为35 2 %。仅2例患儿血红蛋白降低。结论 采用聚乙二醇α2a干扰素联合利巴韦林治疗小儿CHC取得较高的病毒学应答,没有发生严重的不良反应。
Objective To prospectively conduct antiviral treatment of 54 chronic hepatitis C (CHC) patients with pegylated interferon-α2a in children. Methods IFN-α1 ~ 3MIU induction therapy, the dose of polyethylene glycol α2a interferon per week 104μg m2 body surface area. Ribavirin dose of 15 ~ 20mg · kg 1 · d 1. Results Forty-two to six percent of CHC patients failed treatment with standard interferon-alpha combined with ribavirin, and 70.8% of the children were HCVRNA genotype Ⅰ; 14.8% of children with high viral load. Three months after the combination therapy 87 5% of children with HCVRNA negative conversion, 83% HCVRNA decline ≥ 2log. After 6 months of treatment, 87.9% of HCVRNA was negative and 6 1% of HCVRNA was decreased by> 2log. Children with mild flu-like symptoms were 51.9% with fever of 481% and were mostly fever. 4 36% of weakness, 9 3% loss of appetite, rash 37%. Children with blood neutrophil count ≤ 210 × 10 9 L 94 4%, of which <10 × 10 9 L 35 2%. Only 2 patients had hemoglobin decreased. Conclusions Polyethylene glycol α2a interferon combined with ribavirin treatment of pediatric CHC achieved a higher virological response, no serious adverse reactions.