Shiratori Y, Kato N, Yoshida H, Imazeki F, Okano K, Yokosuka O, Omata M
Department of Internal Medicine (II), University of Tokyo, Japan.
J Gastroenterol Hepatol. 1999 Jan;14(1):79-84. doi: 10.1046/j.1440-1746.1999.01802.x.
Hepatitis C virus (HCV)-RNA status and alanine aminotransferase (ALT) levels determined shortly after interferon (IFN) therapy in patients with chronic hepatitis C do not predict long-term response. To determine the virological sustained response after the completion of IFN therapy, HCV-RNA was measured at the end of treatment and at 3-4 months and 12 months after the completion of therapy in 537 patients with chronic hepatitis C. In 347 patients, HCV-RNA was not detected by polymerase chain reaction (PCR) at the completion of therapy and 175 of these patients (50%) were still PCR negative 12 months later. In contrast, of the 180 patients who were HCV-RNA negative at 3-4 months after completion of therapy, 99% remained negative at 12 months. Normal ALT levels were found in 80, 93 and 95% of patients who were negative for HCV-RNA either at the end of treatment or at 3-4 months and 12 months after the completion of therapy, respectively. Of patients who were HCV-RNA positive, 30, 15 and 20% were found to have normal ALT levels at the same respective time points. To determine a sustained virological response shortly after the completion of therapy, serum HCV-RNA was serially examined in 66 patients negative for HCV-RNA at the end of therapy. Of 31 patients who relapsed, HCV-RNA reappeared in 33, 80, 97 and 100% of patients by 1, 2, 4 and 8 weeks after the completion of therapy. In conclusion, a sustained virological response could be determined with 97 and 99% certainty at 4 weeks and at 3-4 months after the completion of therapy, respectively.
慢性丙型肝炎患者接受干扰素（IFN）治疗后不久测定的丙型肝炎病毒（HCV）-RNA状态和丙氨酸转氨酶（ALT）水平不能预测长期疗效。为了确定IFN治疗结束后的病毒学持续应答情况，对537例慢性丙型肝炎患者在治疗结束时、治疗结束后3 - 4个月及12个月检测HCV-RNA。347例患者在治疗结束时通过聚合酶链反应（PCR）未检测到HCV-RNA，其中175例患者（50%）在12个月后PCR仍为阴性。相比之下，在治疗结束后3 - 4个月HCV-RNA阴性的180例患者中，99%在12个月时仍为阴性。治疗结束时、治疗结束后3 - 4个月及12个月HCV-RNA阴性的患者中，分别有80%、93%和95%的患者ALT水平正常。在HCV-RNA阳性的患者中，在相同的各个时间点分别有30%、15%和20%的患者ALT水平正常。为了在治疗结束后不久确定病毒学持续应答情况，对66例治疗结束时HCV-RNA阴性的患者连续检测血清HCV-RNA。在31例复发的患者中，治疗结束后1、2、4和8周，分别有33%、80%、97%和100%的患者HCV-RNA再次出现。总之，治疗结束后4周和3 - 4个月时，分别有97%和99%的把握确定病毒学持续应答。
