Hirsch M S, Schooley R T, Cosimi A B, Russell P S, Delmonico F L, Tolkoff-Rubin N E, Herrin J T, Cantell K, Farrell M L, Rota T R, Rubin R H
N Engl J Med. 1983 Jun 23;308(25):1489-93. doi: 10.1056/NEJM198306233082501.
We have previously demonstrated that six weeks of prophylaxis with interferon-alpha delays cytomegalovirus excretion and decreases viremia in recipients of kidney transplants. In a double-blind trial to evaluate the effects of a longer course of prophylaxis, we gave either 3 X 10(6) units of interferon or placebo intramuscularly to 42 patients before transplant surgery was performed. After surgery, doses were given three times a week for six weeks and then twice a week for eight weeks (total of 102 X 10(6) units). Clinical signs of cytomegalovirus infection were markedly reduced in interferon recipients. These signs developed in 7 of 22 placebo recipients and 1 of 20 interferon recipients (P = 0.03). Opportunistic superinfections (Aspergillus fumigatus and Pneumocystis carinii) occurred only in patients given placebo. Cytomegalovirus-associated glomerulopathy developed in one interferon recipient and three placebo recipients. Survival of patients and grafts was equivalent in both treatment groups, and minimal toxicity was observed with interferon. In seropositive renal-transplant recipients, interferon-alpha affords effective prophylaxis against serious cytomegalovirus infections.
我们之前已经证明，用α干扰素进行六周的预防可延迟巨细胞病毒排泄，并降低肾移植受者的病毒血症。在一项评估更长疗程预防效果的双盲试验中，我们在42例患者进行移植手术前，给他们肌肉注射3×10⁶单位的干扰素或安慰剂。术后，每周给药三次，共六周，然后每周给药两次，共八周（总计102×10⁶单位）。接受干扰素治疗的患者中，巨细胞病毒感染的临床症状明显减轻。这些症状在22例接受安慰剂治疗的患者中有7例出现，而在20例接受干扰素治疗的患者中有1例出现（P = 0.03）。机会性二重感染（烟曲霉和卡氏肺孢子虫）仅发生在接受安慰剂治疗的患者中。一名接受干扰素治疗的患者和三名接受安慰剂治疗的患者发生了巨细胞病毒相关性肾小球病。两个治疗组患者和移植物的存活率相当，且观察到干扰素的毒性极小。在血清学阳性的肾移植受者中，α干扰素可有效预防严重的巨细胞病毒感染。
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