The optimal treatment of hepatitis C virus (HCV) genotype 6 is unclear owing to its limited geographic distribution. Because of a high predictive value of rapid virological response (RVR) for sustained virological response (SVR), we conducted an open-label randomized controlled trial to compare 24- and 48-week peginterferon/ribavirin combination therapy for patients with HCV genotype 6 in Southern China who achieved an RVR.Treatment-naive, non-cirrhotic patients with chronic hepatitis C genotype 6 were treated with pegylated interferon α-2a (180 μg/week) and ribavirin (800-1,200 mg, according to weight) for 4 weeks. Patients who achieved an RVR, which was defined as HCV RNA negativity at week 4 (<50 IU), were randomized to receive either an additional 20 or 44 weeks of treatment (24- and 48-week treatment groups, respectively). The primary outcome measure was SVR. From January 2011 to June 2014, 152(152/210, 72.4%) patients with HCV genotype 6a and RVR were randomized 1:1 to the 24- or 48-week treatment group. The SVR rates in the 24- and 48-week groups in the intention-to-treat analysis were 90.8% (69/76) and 88.2% (67/76), respectively; those in the per-protocol analysis were 95.7% (67/70) and 97.0% (64/66), respectively. More patients in the 48-week group had anemia (46.1% vs. 28.9%, P = 0.03), but other adverse events were comparable between the groups. The limitation of the present study was that only patients from Southern China were enrolled which may inhibit the extensive application of the findings.Twenty-four weeks of peginterferon/ribavirin combination therapy was non-inferior to 48 weeks in patients with HCV genotype 6a in Southern China who achieved an RVR.ClinicalTrials.gov NCT01263860.

Objective To investigate the clinical features of chronic hepatitis B virus (HBV) infected patients superinfected with hepatitis E virus (HEV),and the risk factors of acute sporadic HEV case.Explore reasonable treatment to reduce the incidence of severe viral hepatitis and mortality in the HBV/HEV superinfection.Methods The clinical characteristics of the patients with HBV and HEV superinfection were compared with those simple HEV infection.Results A total of 115 hepatitis E cases were all acute attack with an average of (42 ± 15) years old and the ratio of male to female was 2.83∶ 1.The 44 cases of them were HBV/HEV superinfection,the other 71 cases were the simple hepatitis E.In the HBV/HEV superinfection group the sever jaundice (TB ＞ 200 μmol/L),the severe abnormal coagulation function( PTA ＜40％ ),the hypoalbuminemia was obviously more than that in the simple hepatitis E group( P ＜ 0.05).The incidence of hepatic encephalopathy was 15.90％,the severe hepatitis rate was 38.64％,obviously higher than that in the simple hepatitis E group (P ＜ 0.05 ).ALSS has good effects in the treatment of the patients with severe viral hepatitis.Conclusions Seafood were the risk factors in the infection of HEV.Superinfection of HBV and HEV can cause chronic and more severe hepatitis,with high mortality.Combined hepatotherapy with ALSS has good effects,the general survival rate is higher,especially in early stage.