Berg T, König V, Küther S, Heuft H G, Wittmann G, Lobeck H, Hopf U
Abteilung für Innere Medizin, Virchow Klinikum, Humboldt Universität, Berlin.
Z Gastroenterol. 1995 Aug;33(8):426-30.
The influence of hepatitis C virus (HCV)-genotypes on the responsiveness to interferon- (IFN-alpha) was studied in 116 patients with proven chronic hepatitis C. 88 of 116 (76%) patients were infected with HCV-genotype 1, 7 (6%) with HCV-genotype 2, and 21 patients (18%) with HCV-genotype 3. All patients received at least 3 MU recombinant IFN-alpha-2a, 2b or lymphoblastoid IFN-alpha tiw for at least 6 month (total IFN-alpha dose per patient 216-720 MU, mean 360; treatment duration 6-12 month, mean 8). The follow-up after cessation of therapy was 9-48 months (mean 25). Sustained normalization of the aminotransferase levels was observed in 20 (17%) of the 116 patients. 10 of the 88 (11%) patients with HCV-genotype 1, 7 of the 21 (33%) patients with HCV-genotype 3 (p < 0.02), and 3 out of the 7 patients with HCV-genotype-2- infection achieved a sustained remission. No response was observed in 58 (66%) and 3 (14%) patients with HCV-genotype 1 and 3 infections, respectively (p < 0.002). All but one of the sustained responders remained HCV-RNA negative during the entire follow-up. There were no significant differences between the sustained responders and the group of non-responders and responders with relapse in relation to age, pretreatment aminotransferase levels, histological activity index, or given IFN-alpha dosage. HCV-genotyping is helpful in evaluating the responsiveness to IFN-alpha and will be of importance considering the indication of therapy.
在116例确诊为慢性丙型肝炎的患者中，研究了丙型肝炎病毒（HCV）基因型对干扰素-α（IFN-α）治疗反应性的影响。116例患者中，88例（76%）感染HCV-1型，7例（6%）感染HCV-2型，21例（18%）感染HCV-3型。所有患者均接受至少3MU重组IFN-α-2a、2b或淋巴母细胞IFN-α，每周3次，持续至少6个月（每位患者的IFN-α总剂量为216 - 720MU，平均360MU；治疗持续时间为6 - 12个月，平均8个月）。治疗停止后的随访时间为9 - 48个月（平均25个月）。116例患者中有20例（17%）实现了转氨酶水平持续正常化。HCV-1型的88例患者中有10例（11%）、HCV-3型的21例患者中有7例（33%）（p < 0.02）以及HCV-2型感染的7例患者中有3例实现了持续缓解。HCV-1型和3型感染的患者分别有58例（66%）和3例（14%）无反应（p < 0.002）。除1例之外，所有持续缓解者在整个随访期间HCV-RNA均为阴性。持续缓解者与无反应者以及复发反应者在年龄、治疗前转氨酶水平、组织学活性指数或给予的IFN-α剂量方面无显著差异。HCV基因分型有助于评估对IFN-α的反应性，并且在考虑治疗指征时具有重要意义。
