Okazaki T, Yoshihara H, Suzuki K, Yamada Y, Tsujimura T, Kawano K, Yamada Y, Abe H
Dept. of Gastroenterology, Osaka Rosai Hospital, Japan.
Scand J Gastroenterol. 1994 Nov;29(11):1039-43. doi: 10.3109/00365529409094883.
Alcohol has been reported to be an important factor that modulates the development and prognosis of chronic viral hepatitis; however, little is known about interaction of alcohol intake and chronic hepatitis C. The aim of this study was to examine whether alcohol drinking affects the effectiveness of interferon (IFN) therapy for chronic hepatitis C.
Thirty-nine patients with chronic hepatitis C were divided into three groups on the basis of the amount of alcohol intake before IFN therapy: group I (n = 15), non-drinkers; group II (n = 14), less than 70 g/day; and group III (n = 10), more than 70 g/day of ethanol intake for at least 10 years. The IFN (total dose, 330 +/- 206 MU) was administered daily for 2 weeks and then intermittently. Drinkers stayed abstinent for at least 1 month before, during, and after IFN therapy. The sustained responder was defined as the patient who showed normal alanine aminotransferase (ALAT) levels continuously for more than 6 months after the therapy. The liver histology (HAI score) and serum hepatitis C virus (HCV) RNA were also examined before and after the therapy.
There was no significant difference among the three groups in the level of ALAT before IFN therapy, age, total dose of IFN, and liver histology. The rates of sustained responders in groups I, II, and III were 53.3%, 42.9%, and 0%, respectively, resulting in a significantly lower rate in group III than in groups I (p < 0.01) and II (p < 0.01). The serum HCV-RNA turned negative after the therapy in 58.3%, 20.0%, and 12.5% of groups I, II, and III, respectively, leading to a significantly lower rate of disappearance of HCV-RNA in group III than in group I (p < 0.05).
The IFN therapy for chronic hepatitis C was less effective in heavy drinkers than in non-drinkers.
据报道，酒精是调节慢性病毒性肝炎发生发展及预后的一个重要因素；然而，关于酒精摄入与慢性丙型肝炎之间的相互作用却知之甚少。本研究的目的是探讨饮酒是否会影响干扰素（IFN）治疗慢性丙型肝炎的疗效。
39例慢性丙型肝炎患者在IFN治疗前根据酒精摄入量分为三组：第一组（n = 15），不饮酒者；第二组（n = 14），每日饮酒量少于70克；第三组（n = 10），每日乙醇摄入量超过70克且至少持续10年。IFN（总剂量，330±206 MU）每日给药2周，然后间歇给药。饮酒者在IFN治疗前、治疗期间及治疗后至少戒酒1个月。持续应答者定义为治疗后丙氨酸氨基转移酶（ALAT）水平持续正常超过6个月的患者。治疗前后还检查了肝脏组织学（HAI评分）和血清丙型肝炎病毒（HCV）RNA。
三组患者在IFN治疗前的ALAT水平、年龄、IFN总剂量及肝脏组织学方面无显著差异。第一组、第二组和第三组的持续应答率分别为53.3%、42.9%和0%，第三组的持续应答率显著低于第一组（p < 0.01）和第二组（p < 0.01）。治疗后，第一组、第二组和第三组血清HCV - RNA转阴率分别为58.3%、20.0%和12.5%，第三组HCV - RNA消失率显著低于第一组（p < 0.05）。
对于慢性丙型肝炎，IFN治疗在重度饮酒者中的效果不如非饮酒者。
