Camps J, García-Granero M, Riezu-Boj J I, Larrea E, de Alava E, Civeira M P, Castilla A, Prieto J
Department of Internal Medicine, Clínica Universitaria, Universidad de Navarra, Pamplona, Spain.
J Hepatol. 1994 Jul;21(1):4-11. doi: 10.1016/s0168-8278(94)80129-0.
alpha-Interferon therapy normalizes aminotransferase levels in approximately 50% of the patients with chronic hepatitis C, but post-therapy relapses are common and predictive factors of sustained response remain largely unknown. We retrospectively assessed several parameters as predictors of sustained remission after a 12-month course of lymphoblastoid alpha-interferon: the Knodell histological activity index, serum levels of procollagen type III peptide, serum HCV-RNA, anti-alpha-interferon antibodies, and anti-HCV antibodies (C-100-3), all at month 12. Thirty-seven patients were studied. Fourteen patients were non-responders (38%), 15 patients experienced a sustained response (40.5%) and eight patients responded similarly but relapsed after alpha-interferon withdrawal (21.5%). A decrease in the histological activity index above 5, normalization of procollagen type III peptide levels (< 12 ng/ml) and the absence of viremia after treatment were all significantly associated with a sustained response (p = 0.008, p = 0.007 and p = 0.037, respectively). Anti-interferon antibodies were detected in only one non-responder patient. Anti-C-100-3 antibodies became undetectable at month 12 in 5 of the 15 sustained responders. The best prediction of sustained response was obtained from the three variables independent of multivariate analysis according to the following equation: F = 0.872 + 0.067 x K (decrease of histological index) -0.052 x P (procollagen type III peptide levels at month 12) -0.28 x R (HCV-RNA at month 12; R = 2 when present and R = 1 when absent). A score higher than 0 predicted sustained remission with a 100% sensitivity and specificity in this series of patients.(ABSTRACT TRUNCATED AT 250 WORDS)
α干扰素疗法可使约50%的慢性丙型肝炎患者的转氨酶水平恢复正常，但治疗后复发很常见，且持续应答的预测因素在很大程度上仍不清楚。我们回顾性评估了几个参数，作为淋巴母细胞α干扰素治疗12个月疗程后持续缓解的预测指标：第12个月时的Knodell组织学活动指数、血清III型前胶原肽水平、血清HCV-RNA、抗α干扰素抗体和抗HCV抗体（C-100-3）。研究了37例患者。14例患者无应答（38%），15例患者获得持续应答（40.5%），8例患者应答相似但在停用α干扰素后复发（21.5%）。组织学活动指数下降超过5、III型前胶原肽水平恢复正常（<12 ng/ml）以及治疗后无病毒血症均与持续应答显著相关（分别为p = 0.008、p = 0.007和p = 0.037）。仅在1例无应答患者中检测到抗干扰素抗体。15例持续应答者中有5例在第12个月时抗C-100-3抗体检测不到。根据以下方程，通过多变量分析独立的三个变量可获得持续应答的最佳预测：F = 0.872 + 0.067 x K（组织学指数下降）-0.052 x P（第12个月时的III型前胶原肽水平）-0.28 x R（第12个月时的HCV-RNA；存在时R = 2，不存在时R = 1）。在这组患者中，得分高于0预测持续缓解的敏感性和特异性均为100%。（摘要截短于250字）
