Lang Z, Zhao C, Xu D
Beijing Youan Hospital, Beijing, China.
Zhonghua Gan Zang Bing Za Zhi. 2001 Jun;9(3):145-7.
To investigate the histological changes in liver biopsies and HBV DNA changes in sera induced by 18 weeks of interferon alpha-2b therapy in patients with chronic hepatitis B infection.
Twenty-two patients were enrolled into this prospective study. All patients had a liver biopsy within 1 week before starting interferon therapy. Interferon alpha-2b was given at a dose of 3MU thrice a week for 18 weeks. A second liver biopsy was taken for comparison at the end of week 18. Blinded biopsies were scored according to Knodell's histology activity index (HAI), and examined for HBsAg, HBeAg, HBcAg and alpha - SMA by immunohistochemistry. The serum samples corresponding with liver biopsies were collected and HBV DNA, e-antigen were measured.
Histological assessment revealed a significant improvement in intralobular inflammation and periportal necrosis after treatment(P<0.01). Fifty-five percent (12/22) patients had a reduction of hepatic necroinflammatory HAI score at the end of 18 weeks of interferon alpha-2b therapy compared to pretreatment values, but periportal inflammation and fibrosis failed to show improvement. HBeAg disappeared from liver tissues in 7 from 13 cases(53.8%)and a significant reduction of activated liver stellate cells was demonstrated in biopsies performed after suspending the interferon treatment(P=0.0004). Serum HBV DNA levels decreased significantly after treatment (P<0.01). The clearance rate of HBeAg was 42.9% after treatment. There was no significant difference between HBeAg positive and negative patients either in liver histological improvements or declining level of serum HBV DNA.
Interferon alpha-2b may decrease the level of serum HBV DNA in the patients with chronic hepatitis B infection, and improve their necroinflammation in liver tissues.
研究慢性乙型肝炎感染患者接受18周α-2b干扰素治疗后肝活检的组织学变化及血清中HBV DNA的变化。
22例患者纳入该前瞻性研究。所有患者在开始干扰素治疗前1周内进行肝活检。α-2b干扰素以3MU的剂量每周三次给药，共18周。在第18周结束时进行第二次肝活检以作比较。盲法活检根据Knodell组织学活动指数（HAI）评分，并通过免疫组织化学检查HBsAg、HBeAg、HBcAg和α-SMA。收集与肝活检对应的血清样本并检测HBV DNA、e抗原。
组织学评估显示治疗后小叶内炎症和汇管区坏死有显著改善（P<0.01）。与治疗前相比，55%（12/22）的患者在18周α-2b干扰素治疗结束时肝坏死性炎症HAI评分降低，但汇管区炎症和纤维化未显示改善。13例中有7例（53.8%）肝组织中的HBeAg消失，且在停用干扰素治疗后进行的活检中显示活化的肝星状细胞显著减少（P=0.0004）。治疗后血清HBV DNA水平显著下降（P<0.01）。治疗后HBeAg清除率为42.9%。HBeAg阳性和阴性患者在肝组织学改善或血清HBV DNA水平下降方面均无显著差异。
α-2b干扰素可能降低慢性乙型肝炎感染患者的血清HBV DNA水平，并改善其肝组织坏死性炎症。
