Brook M G, Petrovic L, McDonald J A, Scheuer P J, Thomas H C
Department of Infectious Diseases, Royal Free Hospital, London, U.K.
J Hepatol. 1989 Mar;8(2):218-25. doi: 10.1016/0168-8278(89)90010-x.
Sequential liver biopsies were taken from 66 patients with chronic hepatitis B virus (HBV) infection being followed in randomised controlled trials of therapy with alpha interferons or adenine arabinoside 5'-monophosphate. In the group of 23 patients responding to treatment with the permanent loss of HBe antigen and HBV-DNA from their serum, there was a significant reduction in hepatic inflammatory activity and none developed cirrhosis. In contrast, inflammatory activity continued in the group of 24 patients that did not respond to therapy, and in the group of 19 patients who received no therapy. Two untreated controls progressed to cirrhosis. Further studies confirmed that in those clearing HBeAg and HBV-DNA from the serum, HBcAg and HBeAg were also lost from the liver. This study demonstrates that, as in natural seroconversion, successful treatment of chronic HBV infection is associated with loss of hepatic as well as serum markers of HBV replication, and is followed by a reduction in hepatic inflammation. Antiviral therapy may prevent progression to cirrhosis in some cases.
在使用α干扰素或阿糖腺苷5'-单磷酸进行治疗的随机对照试验中，对66例慢性乙型肝炎病毒（HBV）感染患者进行了序贯肝活检。在23例血清中HBe抗原和HBV-DNA持续消失且对治疗有反应的患者组中，肝脏炎症活动显著减轻，无一例发生肝硬化。相比之下，24例对治疗无反应的患者组以及19例未接受治疗的患者组中，炎症活动持续存在。两名未治疗的对照患者进展为肝硬化。进一步研究证实，在那些血清中清除HBeAg和HBV-DNA的患者中，肝内的HBcAg和HBeAg也消失了。这项研究表明，与自然血清学转换一样，慢性HBV感染的成功治疗与肝脏以及血清中HBV复制标志物的消失有关，并伴有肝脏炎症的减轻。抗病毒治疗在某些情况下可能会预防肝硬化的进展。
