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对慢性丙型肝炎病毒感染患者进行2年或更长时间的干扰素治疗可降低肝癌发生的几率。

Interferon therapy for 2 years or longer reduces the incidence of hepatocarcinogenesis in patients with chronic hepatitis C viral infection.

作者信息

Arase Yasuji, Ikeda Kenji, Tsubota Akihito, Suzuki Fumitaka, Suzuki Yoshiyuki, Saitoh Satoshi, Kobayashi Masahiro, Akuta Norio, Someya Takashi, Hosaka Tetsuya, Sezaki Hitomi, Kobayashi Mariko, Kumada Hiromitsu

机构信息

Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.

出版信息

Intervirology. 2004;47(6):355-61. doi: 10.1159/000080880.

Abstract

OBJECTIVE

The purpose of this clinical study was to determine the effect of long-term interferon (IFN) administration on the incidence of hepatocellular carcinomas (HCC) in chronic hepatitis C patients, without eradication of hepatitis C virus (HCV) by IFN therapy.

METHODS

The number of patients with biopsy-proven chronic hepatitis with moderate or severe staging, HCV genotype 1b, a high viral load exceeding 1 MEq/ml (mega equivalents per milliliter), who received 6 MU of natural IFN-alpha daily for 2-8 weeks, followed by three times/week for 16-22 weeks, as initial IFN therapy, and positivity for HCV RNA during IFN administration was 131. 47 of the 131 patients continued to be treated with IFN (long-term IFN group, dose 3 or 6 MU twice or three times weekly for 1.5-10.5 years, median 4.0 years) after initial IFN therapy, while 84 patients did not receive any IFN therapy apart from the initial 6-month course (no-add-IFN group). The patients were prospectively monitored, and the cumulative incidence of HCC and risk factors for HCC were examined.

RESULTS

The 5- and 10-year cumulative rates of HCC were 1.9 and 6.4% and 1.9 and 26.8% for long-term IFN and no-add-IFN groups, respectively. Cox regression analysis indicated that the relative risk of HCC in the patients of the no-add-IFN group was 8.72 times of that in patients of the long-term IFN group.

CONCLUSION

Long-term IFN therapy in patients with chronic HCV infection is effective in preventing hepatocarcinogenesis.

摘要

目的

本临床研究旨在确定在慢性丙型肝炎患者中,长期给予干扰素(IFN)但未通过IFN治疗根除丙型肝炎病毒(HCV)时,对肝细胞癌(HCC)发生率的影响。

方法

经活检证实为中度或重度分期的慢性肝炎患者,HCV基因型为1b,病毒载量高,超过1 MEq/ml(每毫升百万当量),作为初始IFN治疗,每天接受6 MU天然α干扰素治疗2 - 8周,随后每周三次,持续16 - 22周,且在IFN给药期间HCV RNA呈阳性的患者有131例。131例患者中,47例在初始IFN治疗后继续接受IFN治疗(长期IFN组,剂量为3或6 MU,每周两次或三次,持续1.5 - 10.5年,中位时间为4.0年),而84例患者除了最初6个月疗程外未接受任何IFN治疗(无追加IFN组)。对患者进行前瞻性监测,并检查HCC的累积发生率和HCC的危险因素。

结果

长期IFN组和无追加IFN组的HCC 5年和10年累积发生率分别为1.9%和6.4%以及1.9%和26.8%。Cox回归分析表明,无追加IFN组患者发生HCC的相对风险是长期IFN组患者的8.72倍。

结论

慢性HCV感染患者的长期IFN治疗可有效预防肝癌发生。

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