Ohnishi K, Nomura F, Nakano M
First Department of Medicine, School of Medicine, Chiba University, Japan.
Am J Gastroenterol. 1991 Aug;86(8):1041-9.
To assess the effect of interferon therapy on posttransfusion non-A, non-B acute hepatitis, we examined the appearance of serum hepatitis C virus antibody (anti-HCV) and abnormal serum aminotransferase levels after the onset of hepatitis in 12 patients treated with interferon and in 46 patients treated conservatively. Eleven patients were given 3 million units of human fibroblast beta-interferon three times weekly for 4 wk and 1 was given one million units of human lymphoblastoid alpha-interferon daily for 3 months. In the interferon-treated patients, the effect of therapy on hepatic histology was also assessed. Detection of anti-HCV within 6 and 12 months after the onset of hepatitis was less common in interferon-treated patients than in control patients (6/12 vs 35/46 and 5/12 vs 35/46, both p = NS). At 24 months after the onset of hepatitis, anti-HCV levels were significantly lower in interferon-treated patients (0/10, p less than 0.05), but had not changed significantly in control patients (34/46). Abnormal serum aminotransferase levels at 6, 12, and 24 months after the onset of hepatitis were significantly less common in interferon-treated patients than in controls (25% vs 78.3%, p less than 0.005; 25% vs 71.7%, p less than 0.01; and 0% vs 67.4%, p less than 0.001). The percentage of abnormal serum aminotransferase levels at 6, 12, and 24 months after onset of hepatitis was also less in interferon-treated patients than in control patients, both among anti-HCV-positive patients (50% vs 85.7%, p = NS; 50% vs 80%, p = NS; and 0% vs 77.1%, p less than 0.01) and among anti-HCV-negative patients (0% vs 54.5%, p = NS; 0% vs 45.5%, p = NS; and 0% vs 27.3%, p = NS). Immediately after interferon therapy, the histological activity index dropped from 6.0 +/- 4.2 to 4.8 +/- 2.5 in anti-HCV-positive patients (p = NS) and from 4.2 +/- 4.3 to 2.6 +/- 1.7 in anti-HCV-negative patients (p = NS). Biopsy specimens obtained from four patients 12-23 months after interferon therapy revealed normal histology in one anti-HCV-positive patient and two anti-HCV-negative patients, and marked improvement in the other anti-HCV-positive patient. These results indicate that short-term, low-dose interferon therapy may be effective for posttransfusion non-A, non-B acute hepatitis (both anti-HCV-positive and anti-HCV-negative).
为评估干扰素治疗对输血后非甲非乙型急性肝炎的疗效，我们检测了12例接受干扰素治疗的患者和46例接受保守治疗的患者肝炎发病后血清丙型肝炎病毒抗体（抗-HCV）的出现情况以及血清转氨酶水平异常情况。11例患者每周3次，每次给予300万单位人成纤维细胞β干扰素，共4周；1例患者每日给予100万单位人淋巴母细胞α干扰素，共3个月。对接受干扰素治疗的患者，还评估了治疗对肝脏组织学的影响。肝炎发病后6个月和12个月时，接受干扰素治疗的患者中抗-HCV的检出率低于对照患者（分别为6/12 vs 35/46和5/12 vs 35/46，两者p值均无统计学意义）。肝炎发病后24个月时，接受干扰素治疗的患者抗-HCV水平显著降低（0/10，p<0.05），而对照患者无显著变化（34/46）。肝炎发病后6个月、12个月和24个月时，接受干扰素治疗的患者血清转氨酶水平异常的情况显著少于对照患者（分别为25% vs 78.3%，p<0.005；25% vs 71.7%，p<0.01；0% vs 67.4%，p<0.001）。肝炎发病后6个月、12个月和24个月时，抗-HCV阳性患者和抗-HCV阴性患者中，接受干扰素治疗的患者血清转氨酶水平异常的百分比也低于对照患者（抗-HCV阳性患者中分别为50% vs 85.7%，p值无统计学意义；50% vs 80%，p值无统计学意义；0% vs 77.1%，p<0.01；抗-HCV阴性患者中分别为0% vs 54.5%，p值无统计学意义；0% vs 45.5%，p值无统计学意义；0% vs 27.3%，p值无统计学意义）。干扰素治疗后即刻，抗-HCV阳性患者的组织学活动指数从6.0±4.2降至4.8±2.5（p值无统计学意义），抗-HCV阴性患者从4.2±4.3降至2.6±1.7（p值无统计学意义）。在干扰素治疗后12 - 23个月从4例患者获取的活检标本显示，1例抗-HCV阳性患者和2例抗-HCV阴性患者组织学正常，另1例抗-HCV阳性患者有明显改善。这些结果表明，短期、小剂量干扰素治疗可能对输血后非甲非乙型急性肝炎（抗-HCV阳性和抗-HCV阴性患者均有效）。
