Nadeem Amina, Hussain Muhammad Mazhar, Aslam Muhammad, Hussain Tassawar, Butt Idrees Farooq, Ali Khan Saadat, Asad Ambreen
Department of Physiology, Army Medical College, Rawalpindi, Pakistan.
J Ayub Med Coll Abbottabad. 2009 Apr-Jun;21(2):103-6.
Raised serum alanine aminotransferase (serum ALT) levels indicate active liver disease while liver biopsy has been considered the 'gold standard' for assessing the severity of disease in patients of chronic Hepatitis C. The response of these patients to standard treatment regimen of interferon (INF)-alpha-2b and ribavirin for 24 weeks have been studied.
The objective of this study was to evaluate the association of response to combined INF alpha-2b and ribavirin therapy in patients of chronic hepatitis C with serum ALT levels and severity of the disease on liver biopsy.
This quasi experimental study-was conducted in Department of Physiology at Army Medical College and Military Hospital, Rawalpindi from January 2006 to February 2007. One hundred and seven diagnosed non cirrhotic chronic hepatitis C patients were studied. Prior to the commencement of treatment, qualitative assay of Hepatitis C Virus (HCV) Ribonucleic Acid (RNA) was done by Polymerase chain reaction (PCR). Knodell Histopathological Index (HPI) was determined on liver biopsy. The standard treatment of INF-alpha-2b, 3 million units 3 times a week subcutaneous, and Ribavirin 800-1200 mg per day was given for 24 weeks. Serum ALT levels were determined before the start of treatment and later at weeks 12 and 24. Qualitative assay of HCV RNA was done by PCR at the end of treatment to determine the response to treatment. Statistical analysis was done on SPSS 15.
Out of 107 patients of chronic hepatitis C, 92 (69 males, 23 females) patients (84%) responded to INF-alpha-2b and ribavirin therapy and revealed negative qualitative assay of HCV RNA by PCR at the end of 24 weeks of treatment while serum ALT levels were normal in 88% of patients at 12 weeks and in 97% at the end of 24 weeks of treatment. Knodell HPI revealed mild, moderate and severe disease in 47.7%, 39.9% and 13.1% of patients respectively. No association was established between response to treatment and severity of the disease on liver biopsy (p < 0.11) and serum ALT levels (p = 0.09).
Response to Interferon alpha-2b and ribavirin therapy in patients of chronic hepatitis C is not associated with the levels of serum ALT and the severity of the illness graded on liver biopsy.
血清丙氨酸氨基转移酶（血清ALT）水平升高表明存在活动性肝病，而肝活检一直被视为评估慢性丙型肝炎患者疾病严重程度的“金标准”。对这些患者采用干扰素（INF）-α-2b和利巴韦林标准治疗方案进行24周的治疗反应进行了研究。
本研究的目的是评估慢性丙型肝炎患者对联合使用INFα-2b和利巴韦林治疗的反应与血清ALT水平及肝活检疾病严重程度之间的关联。
本准实验研究于2006年1月至2007年2月在拉瓦尔品第陆军医学院生理学系和军事医院进行。对107例确诊的非肝硬化慢性丙型肝炎患者进行了研究。在开始治疗前，通过聚合酶链反应（PCR）对丙型肝炎病毒（HCV）核糖核酸（RNA）进行定性检测。通过肝活检确定Knodell组织病理学指数（HPI）。给予标准治疗方案，即皮下注射INF-α-2b，300万单位，每周3次，以及利巴韦林每天800 - 1200毫克，持续24周。在治疗开始前、第12周和第24周测定血清ALT水平。治疗结束时通过PCR对HCV RNA进行定性检测以确定治疗反应。使用SPSS 15进行统计分析。
在107例慢性丙型肝炎患者中，92例（69例男性，23例女性）患者（84%）对INF-α-2b和利巴韦林治疗有反应，在24周治疗结束时通过PCR检测显示HCV RNA定性检测为阴性，而在治疗12周时88%的患者血清ALT水平正常，在24周治疗结束时97%的患者血清ALT水平正常。Knodell HPI显示分别有47.7%、39.9%和13.1%的患者患有轻度、中度和重度疾病。治疗反应与肝活检疾病严重程度（p < 0.11）和血清ALT水平（p = 0.09）之间未建立关联。
慢性丙型肝炎患者对干扰素α-2b和利巴韦林治疗的反应与血清ALT水平及肝活检分级的疾病严重程度无关。
