Yamada G, Takatani M, Kishi F, Takahashi M, Doi T, Tsuji T, Shin S, Tanno M, Urdea M S, Kolberg J A
First Department of Internal Medicine, Okayama University Medical School, Japan.
Hepatology. 1995 Nov;22(5):1351-4.
To clarify the viral factors that may predict the therapeutic effect of interferon (IFN) in chronic hepatitis C (CHC) patients, we investigated the quantitative serum hepatitis C virus (HCV) RNA level, genotype, and liver biopsy histological features in 60 patients who were treated with 360 x 10(6) U of natural IFN-alpha for 36 to 48 weeks and for more than 12 months after therapy. A branched DNA (bDNA) assay was used to measure HCV RNA levels. All responders, defined as those individuals with normal alanine transaminase (ALT) levels at 48 weeks after therapy, had less than 2 x 10(6) HCV RNA Eq/mL before administration of IFN. Of 39 patients with RNA levels (less than 2 x 10(6) Eq/L) 23 (59.0%) were responders. The genotype was determined for each patient using type-specific polymerase chain reaction (PCR) primers. There was a significant difference in rate of response between subtype 1b and subtypes 2a and 2b (P < .0002); however, all responders had less than 2 x 10(6) Eq/L independent of genotype. In a multivariate analysis, RNA level was the most statistically significant factor affecting response to IFN. Although disease severity, as defined by histological features, was not statistically correlated with nonresponse, patients that responded to IFN tended to have less severe disease.
为了阐明可能预测干扰素（IFN）对慢性丙型肝炎（CHC）患者治疗效果的病毒因素，我们对60例患者进行了研究，这些患者接受360×10⁶U天然α干扰素治疗36至48周，并在治疗后随访超过12个月。采用分支DNA（bDNA）分析法检测血清丙型肝炎病毒（HCV）RNA水平。所有应答者定义为治疗后48周丙氨酸转氨酶（ALT）水平正常的患者，在给予干扰素前HCV RNA水平均低于2×10⁶Eq/mL。在39例RNA水平低于2×10⁶Eq/L的患者中，23例（59.0%）为应答者。使用型特异性聚合酶链反应（PCR）引物对每位患者进行基因分型。1b亚型与2a和2b亚型的应答率有显著差异（P<0.0002）；然而，所有应答者的RNA水平均低于2×10⁶Eq/L，与基因型无关。多因素分析显示，RNA水平是影响干扰素应答的最具统计学意义的因素。虽然根据组织学特征定义的疾病严重程度与无应答无统计学相关性，但对干扰素应答的患者往往疾病较轻。
