Scullard G H, Smith C I, Merigan T C, Robinson W S, Gregory P B
Gastroenterology. 1981 Dec;81(6):987-91.
Hepatitis B virus associated DNA polymerase activity, hepatitis b surface antigen (HBsAg), and serum aspartate aminotransferase were followed in 21 patients with chronic active hepatitis while immunosuppressive therapy (prednisone +/- azathioprine) was being withdrawn. In every case, DNA polymerase activity fell within 6-10 wk of decreasing treatment and became undetectable in 8 patients. This was usually accompanied by a fall in HbsAg titer and a transient rise in serum aspartate aminotransferase activity. Four additional patients with previously untreated HbsAg positive chronic active hepatitis were placed on prednisone for 12 wk. There was a rise in DNA polymerase activity and HBsAg titer with a fall in serum aspartate aminotransferase values during treatment. Upon discontinuing therapy, DNa polymerase activity fell dramatically in all 3 patients who completed their course of prednisone and became undetectable in 1. These findings suggest that immunosuppressive therapy has a potentiating effect on hepatitis B viral replication in patients with chronic active hepatitis.
在21例慢性活动性肝炎患者停用免疫抑制治疗（泼尼松±硫唑嘌呤）期间，对乙肝病毒相关DNA聚合酶活性、乙肝表面抗原（HBsAg）和血清天冬氨酸氨基转移酶进行了跟踪观察。在每一例中，DNA聚合酶活性在治疗减量后的6 - 10周内下降，8例患者的该活性变得无法检测到。这通常伴随着HBsAg滴度下降以及血清天冬氨酸氨基转移酶活性短暂升高。另外4例先前未经治疗的HBsAg阳性慢性活动性肝炎患者接受了12周的泼尼松治疗。治疗期间，DNA聚合酶活性和HBsAg滴度升高，血清天冬氨酸氨基转移酶值下降。停止治疗后，完成泼尼松疗程的所有3例患者的DNA聚合酶活性急剧下降，其中1例变得无法检测到。这些发现提示，免疫抑制治疗对慢性活动性肝炎患者的乙肝病毒复制有增强作用。
