Kusaka S, Okusa T, Araki A, Fujiki K, Takashimizu I, Okayasu I, Yamamoto N, Sato C
First Department of Internal Medicine, Faculty of Medicine, Tokyo Medical and Dental University, Japan.
J Med Virol. 1995 Jul;46(3):265-8. doi: 10.1002/jmv.1890460317.
To investigate the predictive value of hepatitis C virus (HCV)-RNA in peripheral blood mononuclear cells in the response to interferon therapy in patients with chronic hepatitis C, 15 patients with histologically proven chronic active hepatitis and who were positive for serum HCV-RNA were treated with interferon-alpha (6 million units; i.m.) every day for two weeks and then three times a week for 22 weeks. Ten of the 15 patients were responders whose alanine aminotransferase levels decreased to the normal range at the end of interferon therapy. In four of the 10 responders, HCV-RNA was not detected by reverse transcription-polymerase chain reaction in peripheral blood mononuclear cells nor in serum at the end of treatment. These four patients were complete responders, with alanine aminotransferase levels remaining normal for the next 24 weeks. In five of the 10 responders, HCV-RNA was detected in peripheral blood mononuclear cells but not in serum at the end of treatment. All of these relapsed within the next 24 weeks. In the remaining responder, HCV-RNA was detected both in peripheral blood mononuclear cells and in serum at the end of treatment. This responder also had a relapse within the next 24 weeks. Five of the 15 patients were non-responders, in whom HCV-RNA was detected both in peripheral blood mononuclear cells and in serum. Thus, detection of HCV-RNA in peripheral blood mononuclear cells may be a good clinical marker to predict relapse after interferon treatment.
为研究慢性丙型肝炎患者外周血单个核细胞中丙型肝炎病毒（HCV）-RNA对干扰素治疗反应的预测价值，对15例经组织学证实为慢性活动性肝炎且血清HCV-RNA阳性的患者，给予α干扰素（600万单位；肌肉注射）治疗，每天1次，共2周，之后每周3次，共22周。15例患者中有10例为反应者，在干扰素治疗结束时其丙氨酸氨基转移酶水平降至正常范围。在10例反应者中，有4例在治疗结束时，外周血单个核细胞及血清中经逆转录-聚合酶链反应均未检测到HCV-RNA。这4例患者为完全反应者，在接下来的24周内丙氨酸氨基转移酶水平一直保持正常。10例反应者中有5例在治疗结束时外周血单个核细胞中检测到HCV-RNA，但血清中未检测到。所有这些患者在接下来的24周内均复发。在其余1例反应者中，治疗结束时外周血单个核细胞及血清中均检测到HCV-RNA。该反应者在接下来的24周内也复发。15例患者中有5例为无反应者，其外周血单个核细胞及血清中均检测到HCV-RNA。因此，外周血单个核细胞中HCV-RNA的检测可能是预测干扰素治疗后复发的良好临床指标。
