Suzuki Fumitaka, Arase Yasuji, Akuta Norio, Tsubota Akihito, Suzuki Yoshiyuki, Sezaki Hitomi, Hosaka Tetsuya, Someya Takashi, Kobayashi Masahiro, Saitoh Satoshi, Ikeda Kenji, Kobayashi Mariko, Matsuda Marie, Satoh Junko, Kumada Hiromitsu
Department of Gastroenterology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, 105-8470, Tokyo, Japan.
J Gastroenterol. 2004 Oct;39(10):969-74. doi: 10.1007/s00535-004-1430-x.
In Japan, there are few studies of long-term (more than 1 month) interferon (IFN) therapy for chronic hepatitis B (CHB). In this retrospective study, we investigated the efficacy and predictors of response to 6-month IFN therapy.
We analyzed 66 Japanese patients with CHB who were treated with IFN for 6 months. They comprised patients who were hepatitis B e antigen (HBeAg)-positive (n=45) and -negative (n=21). One (2%), 8 (12%), and 51 (77%) patients were infected with hepatitis B virus (HBV) genotypes A, B, and C, respectively. Responders in patients positive for HBeAg were defined as those who showed normalization of serum alanine aminotransferase (ALT) level, HBeAg loss, and HBV DNA negativity at 6 months after completion of IFN therapy. In patients negative for HBeAg, responders were defined as those patients who showed normalization of ALT level and HBV DNA negativity at the same 6-month time point.
Of the 45 patients with HBeAg at the commencement of IFN therapy, 9 (20%) were responders. Young patients, especially those with a high serum ALT level, were significantly more likely to respond to IFN therapy. Of the 21 patients negative for HBeAg, 13 (62%) were responders. There were no significant differences in clinical characteristics between responders and nonresponders among patients negative for HBeAg. Multivariate analyses identified HBeAg negativity and young age as independent factors associated with a positive response to 6-month IFN therapy. However, long-term follow-up of the treated patients showed a fall in the response rate.
The response rate to 6-month IFN therapy among HBeAg-positive patients was low. However, young patients may require long-term IFN therapy.
在日本，针对慢性乙型肝炎（CHB）进行长期（超过1个月）干扰素（IFN）治疗的研究较少。在这项回顾性研究中，我们调查了6个月IFN治疗的疗效及反应预测因素。
我们分析了66例接受IFN治疗6个月的日本CHB患者。其中包括乙型肝炎e抗原（HBeAg）阳性（n = 45）和阴性（n = 21）的患者。分别有1例（2%）、8例（12%）和51例（77%）患者感染了A型、B型和C型乙型肝炎病毒（HBV）。HBeAg阳性患者的反应者定义为在IFN治疗结束后6个月时血清丙氨酸氨基转移酶（ALT）水平正常、HBeAg消失且HBV DNA阴性的患者。HBeAg阴性患者的反应者定义为在同一6个月时间点ALT水平正常且HBV DNA阴性的患者。
在IFN治疗开始时HBeAg阳性的45例患者中，9例（20%）为反应者。年轻患者，尤其是血清ALT水平高的患者，对IFN治疗反应的可能性显著更高。在HBeAg阴性的21例患者中，13例（62%）为反应者。HBeAg阴性患者中反应者与无反应者的临床特征无显著差异。多因素分析确定HBeAg阴性和年轻是与6个月IFN治疗阳性反应相关的独立因素。然而，对治疗患者的长期随访显示反应率下降。
HBeAg阳性患者对6个月IFN治疗的反应率较低。然而，年轻患者可能需要长期IFN治疗。
