Hayashi J, Ohmiya M, Kishihara Y, Tani Y, Kinukawa N, Ikematsu H, Kashiwagi S
Department of General Medicine, Kyushu University Hospital, Fukuoka, Japan.
Am J Gastroenterol. 1994 Dec;89(12):2151-6.
To determine markers predictive of effective interferon treatment for patients with chronic hepatitis C virus (HCV) infection, we studied 80 Japanese patients treated for 6 months with natural interferon-alpha.
Serum samples were tested for HCV RNA by two-stage polymerase chain reaction (PCR). HCV RNA were grouped into four genotypes by amplification of core-gene sequences by PCR with type-specific primers, and the level of HCV RNA was measured by competitive PCR. HCV RNA was detected in all patients before the interferon treatment. For the purposes of this study, a complete response was defined as the elimination of HCV RNA for at least 6 months after termination of the treatment.
HCV RNA was eliminated from the sera of 27 patients (33.8%) at the termination of the interferon treatment, and the elimination was sustained throughout a 6-month follow-up (complete response). Four of eleven variables proved to be associated with a complete response when assessed by univariate analysis. With multiple logistic regression analysis assessment, however, only two variables (HCV RNA level (p < 0.001) and genotype (p = 0.048)) were significant.
These results suggest that factors associated with the HCV infection are more important than patient characteristics for effective interferon treatment of patients with chronic HCV infection and that a low level of HCV RNA and HCV of genotype III are useful predictors of a complete response.
为了确定预测慢性丙型肝炎病毒(HCV)感染患者干扰素治疗有效的标志物,我们对80例接受天然α干扰素治疗6个月的日本患者进行了研究。
采用两阶段聚合酶链反应(PCR)检测血清样本中的HCV RNA。通过使用型特异性引物的PCR扩增核心基因序列,将HCV RNA分为四种基因型,并通过竞争性PCR测量HCV RNA水平。所有患者在干扰素治疗前均检测到HCV RNA。在本研究中,完全缓解定义为治疗终止后至少6个月内HCV RNA清除。
干扰素治疗结束时,27例患者(33.8%)血清中的HCV RNA被清除,且在6个月的随访期间清除持续存在(完全缓解)。单因素分析评估时,11个变量中有4个与完全缓解相关。然而,通过多因素逻辑回归分析评估,只有两个变量(HCV RNA水平(p < 0.001)和基因型(p = 0.048))具有显著性。
这些结果表明,对于慢性HCV感染患者的有效干扰素治疗,与HCV感染相关的因素比患者特征更重要,并且低水平的HCV RNA和III型HCV是完全缓解的有用预测指标。