Shiffman M L, Stewart C A, Hofmann C M, Contos M J, Luketic V A, Sterling R K, Sanyal A J
Hepatology Section, Medical College of Virginia Commonwealth University, Richmond, VA 23298, USA.
J Infect Dis. 2000 Dec;182(6):1595-601. doi: 10.1086/317612. Epub 2000 Oct 23.
Ninety-five patients with chronic hepatitis C virus (HCV) infection, 35 with persistently normal serum alanine aminotransferase (ALT) levels, were randomized to treatment with daily interferon (IFN) for 3 months, followed by IFN 3 times weekly (TIW) for 12 months (group A) or TIW for 18 months (group B). Patients with elevated versus normal ALT levels had similar demographic and virologic characteristics but significantly (P<.05) more advanced liver histology (bridging fibrosis and cirrhosis, 37.9% vs. 11.4%). After 3 months of treatment, 38.3% of patients in group A were HCV RNA negative versus 18.8% in group B (P<.05). When the IFN dose was reduced from daily to TIW in group A, the percentage of patients who remained HCV RNA negative declined; sustained virologic response was similar in both groups (10.6% vs. 8.3%). Response to treatment was similar in patients with elevated or normal ALT levels. Persons with chronic HCV infection and persistently normal serum ALT levels have milder liver disease than, and respond to IFN therapy similarly to, persons with elevated ALT levels.
95例慢性丙型肝炎病毒（HCV）感染患者，其中35例血清丙氨酸氨基转移酶（ALT）水平持续正常，被随机分为两组：A组接受每日干扰素（IFN）治疗3个月，随后每周3次（TIW）干扰素治疗12个月；B组接受每周3次（TIW）干扰素治疗18个月。ALT水平升高的患者与ALT水平正常的患者在人口统计学和病毒学特征方面相似，但肝组织学表现明显更严重（桥接纤维化和肝硬化，分别为37.9%和11.4%，P<0.05）。治疗3个月后，A组38.3%的患者HCV RNA呈阴性，而B组为18.8%（P<0.05）。当A组的IFN剂量从每日给药减至每周3次给药时，HCV RNA仍为阴性的患者百分比下降；两组的持续病毒学应答相似（分别为10.6%和8.3%）。ALT水平升高或正常的患者对治疗的反应相似。慢性HCV感染且血清ALT水平持续正常的患者，其肝病比ALT水平升高的患者轻，且对IFN治疗的反应相似。
