Hwang S J, Lu R H, Wang Y J, Chu C W, Wu J C, Chang F Y, Lee S D
Department of Medicine, Taipei Veterans General Hospital, Taiwan, ROC.
Zhonghua Yi Xue Za Zhi (Taipei). 2000 Jan;63(1):1-7.
Interferon (IFN) has been used in the treatment of patients with chronic hepatitis B virus (HBV) infection. Nonetheless, the changes in serum HBV DNA titer during IFN treatment and the effect of these changes on the therapeutic results have not been well studied.
Twenty patients with chronic hepatitis B who were positive for serum hepatitis B e antigen (HBeAg) and HBV DNA received IFN-alpha 2a 4.5 million units by subcutaneous injection three times a week for 24 weeks. Twenty age- and sex-matched patients with chronic hepatitis B were selected as a control group. Treatment response was defined as the normalization of serum alanine aminotransferase (ALT) and the seroconversion of serum HBeAg 24 weeks after discontinuation of the IFN treatment. Serum HBV DNA was measured using the branched DNA (bDNA) signal amplification assay.
There was no significant difference in pretreatment mean serum ALT and HBV DNA titer in either the IFN-treated or the control group. Treatment response was found in six (30%) of 20 IFN-treated patients and in four (20%) of 20 control patients (p > 0.05). Serum HBV DNA titer fell after IFN treatment and remained undetectable only in patients with final treatment response. Serum HBV DNA was negative at week 12 of the IFN treatment in four (67%) of six patients with treatment responses, significantly higher than in none (0%) of 14 patients without a treatment response (p = 0.001). Multivariate logistic regression revealed that the negativity of serum HBV DNA at week 12 of the IFN treatment successfully predicted treatment response.
Thirty percent of the patients with chronic hepatitis B responded to IFN-alpha 2a 4.5 million units subcutaneously injected three times a week for 24 weeks. Negativity of serum HBV DNA measured by bDNA assay at week 12 of the IFN treatment may suggest a beneficial treatment outcome.
干扰素（IFN）已用于治疗慢性乙型肝炎病毒（HBV）感染患者。然而，IFN治疗期间血清HBV DNA滴度的变化及其对治疗结果的影响尚未得到充分研究。
20例血清乙肝e抗原（HBeAg）和HBV DNA阳性的慢性乙型肝炎患者，每周皮下注射3次450万单位的α-2a干扰素，共24周。选取20例年龄和性别匹配的慢性乙型肝炎患者作为对照组。治疗反应定义为停止IFN治疗24周后血清丙氨酸氨基转移酶（ALT）正常化和血清HBeAg血清学转换。采用分支DNA（bDNA）信号放大法检测血清HBV DNA。
IFN治疗组和对照组治疗前平均血清ALT和HBV DNA滴度无显著差异。20例接受IFN治疗的患者中有6例（30%）出现治疗反应，20例对照组患者中有4例（20%）出现治疗反应（p>0.05）。IFN治疗后血清HBV DNA滴度下降，仅在最终有治疗反应的患者中检测不到。6例有治疗反应的患者中有4例（67%）在IFN治疗第12周时血清HBV DNA为阴性，显著高于14例无治疗反应患者中的0例（0%）（p = 0.001）。多因素logistic回归显示，IFN治疗第12周时血清HBV DNA阴性成功预测了治疗反应。
30%的慢性乙型肝炎患者对每周皮下注射3次、每次450万单位、共24周的α-2a干扰素治疗有反应。IFN治疗第12周时通过bDNA检测血清HBV DNA阴性可能提示治疗效果良好。
