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预防性人白细胞干扰素在肾移植中的对照临床试验。对巨细胞病毒和单纯疱疹病毒感染的影响。

Controlled clinical trial of prophylactic human-leukocyte interferon in renal transplantation. Effects on cytomegalovirus and herpes simplex virus infections.

作者信息

Cheeseman S H, Rubin R H, Stewart J A, Tolkoff-Rubin N E, Cosimi A B, Cantell K, Gilbert J, Winkle S, Herrin J T, Black P H, Russell P S, Hirsch M S

出版信息

N Engl J Med. 1979 Jun 14;300(24):1345-9. doi: 10.1056/NEJM197906143002401.

Abstract

A double-blind, placebo-controlled trial of interferon prophylaxis against viral infections was conducted in renal-transplant recipients receiving standard immunosuprressive therapy with or without antithymocyte globulin. Interferon was administered for six weeks, beginning on the day of transplantation. Cytomegalovirus excretion began earlier and viremia was more frequent in placebo-treated than in interferon-treated patients. Cytomegalovirus viremia correlated with clinical syndromes was more frequent in recipients of antithymocyte globulin. In contrast, neither interferon nor antithymocyte globulin altered excretion of herpes simplex virus. Reversible leukopenia and thrombocytopenia occurred in seven interferon recipients. Patient and graft survival were comparable in interferon and placebo groups. There preliminary results suggest that a six-week course of prophylactic interferon delays shedding of cytomegalovirus and decreases the incidence of viremia after transplantation. In contrast, antithymocyte globulin appears to increase the severity of infection from cytomegalovirus among these patients.

摘要

在接受标准免疫抑制治疗(使用或不使用抗胸腺细胞球蛋白)的肾移植受者中,开展了一项关于干扰素预防病毒感染的双盲、安慰剂对照试验。从移植当天开始,干扰素给药六周。与接受干扰素治疗的患者相比,接受安慰剂治疗的患者巨细胞病毒排泄开始得更早,病毒血症更频繁。抗胸腺细胞球蛋白受者中与临床综合征相关的巨细胞病毒血症更为常见。相比之下,干扰素和抗胸腺细胞球蛋白均未改变单纯疱疹病毒的排泄情况。7名接受干扰素治疗的患者出现了可逆性白细胞减少和血小板减少。干扰素组和安慰剂组的患者及移植物存活率相当。这些初步结果表明,为期六周的预防性干扰素疗程可延迟巨细胞病毒的排出,并降低移植后病毒血症的发生率。相比之下,抗胸腺细胞球蛋白似乎会增加这些患者中巨细胞病毒感染的严重程度。

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