Guillevin L, Lhote F, Sauvaget F, Deblois P, Rossi F, Levallois D, Pourrat J, Christoforov B, Trépo C
Department of Internal Medicine, Hôpital Avicenne, Stalingrad, Bobigny, France.
Ann Rheum Dis. 1994 May;53(5):334-7. doi: 10.1136/ard.53.5.334.
To test the effectiveness of and tolerance to interferon-alpha 2b (INFa2b) in association with plasma exchanges for the treatment of polyarteritis nodosa (PAN) related to hepatitis B virus (HBV).
A prospective, non blinded, multicentre trial was carried out in which patients with multisystemic HBV-related PAN were included. Each patient received the association of INFa2b and plasma exchanges. The end point of the study was control of the disease (recovery or remission) or death.
Six patients were included in the study. Each patient had histopathological or arteriographic evidence of vasculitis and was infected with actively replicating HBV. All patients were alive at the end of the study and no longer presented clinical or laboratory evidence of systemic vasculitis. HBeAg/anti-HBeAb seroconversion was observed in four patients (66.6%) and HBsAg/anti-HBsAb in 3/6 (50%). Two patients are still being treated with INFa2b because of chronic active hepatitis.
It is considered that this new therapeutic approach to HBV-related PAN effectively cured systemic vasculitis and was associated with control of HBV infections. Antiviral therapy may have a role to play as the first line treatment regime of virus-induced vasculitis.
测试α-干扰素2b（INFa2b）联合血浆置换治疗乙型肝炎病毒（HBV）相关结节性多动脉炎（PAN）的有效性和耐受性。
开展了一项前瞻性、非盲法、多中心试验，纳入多系统HBV相关PAN患者。每位患者接受INFa2b联合血浆置换治疗。研究终点为疾病控制（康复或缓解）或死亡。
6例患者纳入研究。每位患者均有血管炎的组织病理学或血管造影证据，且感染了活跃复制的HBV。研究结束时所有患者均存活，且不再有系统性血管炎的临床或实验室证据。4例患者（66.6%）出现HBeAg/抗-HBeAb血清学转换，3/6（50%）出现HBsAg/抗-HBsAb血清学转换。2例患者因慢性活动性肝炎仍在接受INFa2b治疗。
认为这种针对HBV相关PAN的新治疗方法有效治愈了系统性血管炎，并与HBV感染的控制相关。抗病毒治疗可能作为病毒诱导性血管炎的一线治疗方案发挥作用。
