Huraib S, Tanimu D, Romeh S A, Quadri K, Al Ghamdi G, Iqbal A, Abdulla A
Divisions of Nephrology and Histopathology, King Fahad National Guard Hospital, Riyadh, Saudi Arabia.
Am J Kidney Dis. 1999 Jul;34(1):55-60. doi: 10.1016/s0272-6386(99)70108-3.
This study assesses the efficacy and adverse effects of interferon-alpha (IFN-alpha) administered at a dosage of 3 million units three times weekly for 1 year in 17 hemodialysis patients with hepatitic C virus (HCV)-associated chronic hepatitis (biopsy proven). The patients were prospectively followed up for a period of 18 months. Liver biopsy was repeated after 6 months of treatment in 13 patients. Patients were classified according to the histological activity index. Biochemical and virological responses were evaluated at the end (end-of-treatment response) and 6 months after completion of therapy (sustained response). HCV RNA became negative in 76% of the patients after 12 weeks of treatment, in 88% after 12 months of treatment, and in 71% of the patients 6 months after completion of therapy. HCV genotype 4 was found in 60% of our population. Alanine aminotransferase (ALT) levels were initially increased in only 6 patients and normalized in 4 of these patients after 12 weeks of therapy, with end-of-treatment and sustained biochemical responses of 83% and 67%, respectively. Of 13 patients who underwent liver biopsies after 6 months of therapy, 11 patients (85%) showed histological improvement. One patient could not tolerate therapy because of marked lethargy and myalgia; the other patients had minor side effects that did not require discontinuation of treatment. Two patients received a cadaveric renal transplant after 1 year of IFN treatment, and they continued to maintain biochemical and virological responses after a follow-up of 17 and 28 months, respectively.
本研究评估了17例经活检证实为丙型肝炎病毒（HCV）相关性慢性肝炎的血液透析患者，每周三次、每次300万单位剂量的α干扰素（IFN-α）治疗1年的疗效和不良反应。对患者进行了为期18个月的前瞻性随访。13例患者在治疗6个月后重复进行肝活检。根据组织学活动指数对患者进行分类。在治疗结束时（治疗结束反应）和治疗完成后6个月（持续反应）评估生化和病毒学反应。治疗12周后，76%的患者HCV RNA转为阴性，治疗12个月后为88%，治疗完成后6个月为71%。我们的研究人群中60%为HCV基因型4。最初仅有6例患者丙氨酸氨基转移酶（ALT）水平升高，其中4例患者在治疗12周后恢复正常，治疗结束时和持续生化反应分别为83%和67%。在治疗6个月后接受肝活检的13例患者中，11例（85%）显示组织学改善。1例患者因明显嗜睡和肌痛无法耐受治疗；其他患者有轻微副作用，无需停药。2例患者在IFN治疗1年后接受了尸体肾移植，分别随访17个月和28个月后，他们继续保持生化和病毒学反应。
