Tangkijvanich P, Thong-ngam D, Mahachai V, Kladchareon N, Suwangool P, Kullavanijaya P
Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Southeast Asian J Trop Med Public Health. 2001 Sep;32(3):452-8.
The aim of this study was to assess the long-term effects of interferon (IFN) therapy on the incidence of disease progression to cirrhosis and hepatocellular carcinoma (HCC) in Thai patients with chronic hepatitis B. Sixty-seven patients with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B who received IFN therapy were retrospectively analyzed. The average duration of follow-up was 59.4+/-30.9 months (ranging from 20 to 119 months). Seventy-two untreated patients with comparable clinical data and mean duration of follow-up served as a control group. During follow-up, 24 (35.8%) treated and 7 (9.7%) untreated patients had a sustained loss of HBeAg. However, none of the treated patients or controls became negative for hepatitis B s antigen (HBsAg). Among treated patients, the response was independent of type and dose of IFN, as well as the presence of steroid priming. In addition, 1 of 24 (4.2%) sustained responders and 6 of 43 (14%) non-responders progressed to cirrhosis whereas 16 of 72 (22.2%) in the control group progressed to such sequelae. The overall incidence of new cirrhosis in sustained responders was significantly lower than in the control group (p=0.04). HCC appeared in 11 cirrhotic patients: 9 (12.5%) in the control group and 2 (4.7%) of the non-responders, whereas none of the sustained responders developed HCC. The average period to detection of HCC was 70.5+/-12.4 months for non-responders and 65.3+/-27.6 months for the control group, with no significant differences between these groups. In conclusion, our data suggest that IFN therapy might prevent the progression of cirrhosis and the development of HCC in patients with chronic hepatitis B. These beneficial effects were particularly observed in those who achieved a sustained virological response to treatment.
本研究旨在评估干扰素（IFN）治疗对泰国慢性乙型肝炎患者疾病进展为肝硬化和肝细胞癌（HCC）发生率的长期影响。对67例接受IFN治疗的乙肝e抗原（HBeAg）阳性慢性乙型肝炎患者进行了回顾性分析。平均随访时间为59.4±30.9个月（范围为20至119个月）。72例具有可比临床数据且平均随访时间的未治疗患者作为对照组。随访期间，24例（35.8%）接受治疗的患者和7例（9.7%）未治疗的患者实现了HBeAg的持续转阴。然而，治疗组患者或对照组患者中均无乙肝表面抗原（HBsAg）转阴者。治疗组患者的反应与IFN的类型和剂量以及是否使用类固醇预处理无关。此外，24例持续应答者中有1例（4.2%）、43例无应答者中有6例（14%）进展为肝硬化，而对照组72例中有16例（22.
