慢性丙型肝炎患者对干扰素-α治疗产生有益反应的预测因素

Predictive factors for beneficial response to interferon-alfa therapy in chronic hepatitis C.

作者信息

Yoon S K, Kim S S, Park Y M, Shim K S, Lee C D, Sun H S, Park D H, Kim B S, Ryu W S, Cho J M

机构信息

Department of Internal Medicine, Catholic University Medical College, Seoul, Korea.

出版信息

Korean J Intern Med. 1995 Jul;10(2):94-102. doi: 10.3904/kjim.1995.10.2.94.

DOI:10.3904/kjim.1995.10.2.94

PMID:7495780

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4532038/

Abstract

OBJECTIVES

Interferon is the only established treatment for chronic hepatitis C but the host-dependent or virus-related factors affecting the response rate to interferon therapy are not yet clear. The purpose of this study was to investigate the factors predictive of response to interferon-alfa therapy in chronic hepatitis C.

METHODS

Twenty-five consecutive patients with chronic hepatitis C were randomized to three regimens of interferon-alfa: group A (n = 7, 3 MU every day for 3 months), group B (n = 8, 3 MU every other day for 3 months) and group C (n = 10, 3 MU every other day for 6 months). We quantified serum HC RNA levels by competitive reverse transcription-polymerase chain reaction (RT-PCR) and performed HCV genotyping using type-specific primers deduced form the NS5 region of the HCV genome. We also attempted to identify which demographic, biochemical and histologic factors in addition to virus-related factors would significantly predict beneficial response to interferon by multivariate analysis.

RESULTS

Sustained responders were 8 (36.4%), nonsustained responders were 2 (9.1%) and nonresponders were 12 (54.5%) of 22 patients who had received complete therapy. The initial HCV RNA level (logarithmic transformed copy numbers per ml of serum) in sustained responders (5.75 +/- 0.39) was significantly lower than that of nonsustained responders (6.80 +/- 0.71) and nonresponders (6.70 +/- 0.52) (p < 0.05). In multivariate multiple logistic regression analysis, the serum HCV RNA level before therapy was only the independent predictor of a sustained response to interferon-alfa therapy (p = 0.001).

CONCLUSIONS

Serum HCV RNA level before therapy was the most useful predictor of a sustained response to interferon-alfa therapy for chronic hepatitis C.

摘要

目的

干扰素是目前治疗慢性丙型肝炎的唯一已确立的疗法，但影响干扰素治疗反应率的宿主依赖性或病毒相关因素尚不清楚。本研究的目的是调查预测慢性丙型肝炎患者对α干扰素治疗反应的因素。

方法

25例连续的慢性丙型肝炎患者被随机分为三种α干扰素治疗方案：A组（n = 7，每天3MU，共3个月），B组（n = 8，隔日3MU，共3个月）和C组（n = 10，隔日3MU，共6个月）。我们通过竞争性逆转录-聚合酶链反应（RT-PCR）定量血清HC RNA水平，并使用从HCV基因组NS5区域推导的型特异性引物进行HCV基因分型。我们还试图通过多变量分析确定除病毒相关因素外，哪些人口统计学、生化和组织学因素能显著预测对干扰素的有益反应。

结果

在接受完整治疗的22例患者中，持续应答者为8例（36.4%），非持续应答者为2例（9.1%），无应答者为12例（54.5%）。持续应答者的初始HCV RNA水平（每毫升血清的对数转换拷贝数）（5.75±0.39）显著低于非持续应答者（6.80±0.71）和无应答者（6.70±0.52）（p<0.05）。在多变量多元逻辑回归分析中，治疗前血清HCV RNA水平是对α干扰素治疗持续应答的唯一独立预测因素（p = 0.001）。