Braken J B, Koopmans P P, Van Munster I P, Gribnau F W
Department of Pharmacology, Catholic University Nijmegen, The Netherlands.
Pharm Weekbl Sci. 1992 Aug 21;14(4):167-73. doi: 10.1007/BF01962533.
Interferon alpha is the only available therapy for patients with chronic hepatitis B. With interferon alpha 3-15 MU thrice weekly or 5 MU daily during 3-6 months one-third of the patients achieve seroconversion of HBeAg and HBV-DNA together with normalization of aminotransferases and slight improvement of histology. Loss of HBsAg is reported in a minority of responders during treatment, but increases during follow-up. Patients with baseline alanine aminotransferase of at least twice the upper limit of normal and low HBV-DNA concentration achieve the best response rates. HIV-positive patients with low CD4 counts and Asians are poor responders. As side-effects influenza-like symptoms are experienced by almost all patients. Mild leukopenia, thrombocytopenia and decreased hairgrowth are frequently reported. Severe depression, depersonalization and psychosis are reported in a small number of patients but tend to be poorly recognized in some studies. The decision whether dose reduction is indicated seems strongly related to the opinion of the investigator. Although long-term effects on the occurrence of cirrhosis and the development of hepatocellular carcinoma are not available yet, the achieved results are promising.
α干扰素是慢性乙型肝炎患者唯一可用的治疗方法。使用α干扰素，每周三次，每次3 - 15 MU，或每日5 MU，持续3 - 6个月，三分之一的患者实现HBeAg和HBV - DNA的血清学转换，同时转氨酶恢复正常，组织学有轻微改善。少数应答者在治疗期间报告有HBsAg消失，但在随访期间有所增加。基线丙氨酸转氨酶至少为正常上限两倍且HBV - DNA浓度低的患者应答率最佳。CD4计数低的HIV阳性患者和亚洲人应答较差。几乎所有患者都会出现流感样症状等副作用。经常报告有轻度白细胞减少、血小板减少和毛发增长减少。少数患者报告有严重抑郁、人格解体和精神病，但在一些研究中往往认识不足。是否需要降低剂量的决定似乎与研究者的意见密切相关。虽然对肝硬化发生和肝细胞癌发展的长期影响尚不可知，但已取得的结果很有前景。
