Kullavanuaya P, Treeprasertsuk S, Thong-Ngam D, Chaermthai K, Gonlachanvit S, Suwanagool P
Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
J Med Assoc Thai. 2001 Jun;84 Suppl 1:S462-8.
The efficacy and safety of IFN alpha 2a and Thymosin alpha1 combination therapy in patients with chronic hepatitis C were determined. Twelve chronic hepatitis C patients (9 M, 3F), with positive HCV-RNA and histology compatible with chronic hepatitis C were included in this open, prospective study. Each patient received a combination therapy of IFN alpha 2a 3 mU s.c. TIW and Thymosin alpha1 1.6 mg s.c. twice a week for 52 weeks. Up to the present, 11 patients are still being followed-up after the end of 52 weeks' treatment. One patient dropped out after 32 weeks of follow-up due to noncompliance. Responses to treatment were evaluated by measuring serum HCV-RNA levels determined by RT-PCR. and serum amino transferases at the end of 48 weeks of treatment (end of treatment response: ETR). There were 8 naive and 4 previously IFN treated patients with partial response with a mean age of 45.0 +/- 10.1 (mean +/- SD). The mean duration from diagnosis until treatment was 25.1 +/- 22.9 months. The mean AST, ALT, and HCV-RNA levels before treatment were 79.5 +/- 36.8 U/L, 128.3 +/- 68.5 U/L, and 3.9+1.9 x 10(5) copies/ml respectively. Serum AST, ALT, and HCV-RNA levels were significantly lower at week 24 and 48 after treatment compared to before treatment (p<0.05). Of 11 cases, complete HCV-RNA clearance at week 24 was noted in 33.3 per cent, whereas, normal alanine aminotransferase values (ALT < 40 U/L) were observed in 41.7 per cent of patients. Complete HCV-RNA clearance and normal alanine aminotransferase at week 48 were seen in 45.5 per cent of the patients. At the end of week 48, complete response occurred in 4 of 5 naive patients. Minor side effects were observed during treatment with this combination therapy and these included myalgia (33.3%), mild form of alopecia (33.3%), and weight loss (8.3%). In patients with chronic hepatitis C, Interferon alpha 2a and Thymosin alpha1 combination therapy produced a good response rate especially in naive patients with acceptable safety profile. The sustained response will be determined after the completion of follow-up for another 6 months.
确定了干扰素α 2a与胸腺肽α1联合治疗慢性丙型肝炎患者的疗效和安全性。本开放性前瞻性研究纳入了12例慢性丙型肝炎患者(9例男性,3例女性),其HCV-RNA阳性且组织学表现符合慢性丙型肝炎。每位患者接受干扰素α 2a 3百万单位皮下注射,每周三次,以及胸腺肽α1 1.6毫克皮下注射,每周两次,共治疗52周。截至目前,11例患者在52周治疗结束后仍在接受随访。1例患者在随访32周后因不依从退出。通过测量经逆转录聚合酶链反应测定的血清HCV-RNA水平以及治疗48周结束时(治疗结束反应:ETR)的血清转氨酶来评估治疗反应。有8例初治患者和4例先前接受过干扰素治疗的患者出现部分反应,平均年龄为45.0±10.1(平均值±标准差)。从诊断到治疗的平均持续时间为25.1±22.9个月。治疗前平均AST、ALT和HCV-RNA水平分别为79.5±36.8 U/L、128.3±68.5 U/L和3.9+1.9×10(5)拷贝/毫升。治疗后第24周和第48周时,血清AST、ALT和HCV-RNA水平显著低于治疗前(p<0.05)。11例患者中,24周时33.3%的患者实现了HCV-RNA完全清除,而41.7%的患者丙氨酸转氨酶值正常(ALT<40 U/L)。48周时45.5%的患者实现了HCV-RNA完全清除且丙氨酸转氨酶正常。48周结束时,5例初治患者中有4例出现完全反应。联合治疗期间观察到轻微副作用,包括肌痛(33.3%)、轻度脱发(33.3%)和体重减轻(8.3%)。在慢性丙型肝炎患者中,干扰素α 2a与胸腺肽α1联合治疗产生了良好的反应率,尤其是在初治患者中,且安全性可接受。持续反应将在再随访6个月结束后确定。