Trépo C, Habersetzer F, Bailly F, Berby F, Pichoud C, Berthillon P, Vitvitski L
Service d'Hépato-gastroentérologie, Hopital Hotel-Dieu, Lyon, France.
Antiviral Res. 1994 Jul;24(2-3):155-63. doi: 10.1016/0166-3542(94)90064-7.
Initial trials indicated that around 50% of patients respond to recombinant alpha interferon by normalizing alanine aminotransferase (ALT) at the end of therapy and that half of these relapsed within 6 months following cessation of treatment. Both dose and duration of treatment are critical in the response to therapy. Higher doses and longer duration have been suggested to be more effective than the current recommendations of 3 MUI thrice weekly for 6 months based on results of these initial studies which used ALT and histological scores to evaluate the efficacy of interferon therapy. Following studies using virological markers have shown that improvements in clinical features of disease are associated with decrease or loss of hepatitis C virus (HCV) from serum and liver. The heterogeneity of the response rates between clinical centers using identical protocol emphasizes that the selection of the patients treated was as important for the outcome that the therapy regimen itself with better responses in cases without cirrhosis and with low levels of HCV RNA. Furthermore, the genotype of HCV seems to be also critical for the response rate. Virological evaluations appears therefore crucial to assess not only HCV infection but also for the indication and monitoring of therapy.
初步试验表明，约50%的患者在治疗结束时通过使丙氨酸氨基转移酶（ALT）恢复正常对重组α干扰素产生反应，并且其中一半患者在停止治疗后的6个月内复发。治疗的剂量和疗程对治疗反应都至关重要。根据这些初始研究的结果，更高的剂量和更长的疗程被认为比目前每周三次、每次3 MU、持续6个月的推荐方案更有效，这些初始研究使用ALT和组织学评分来评估干扰素治疗的疗效。随后使用病毒学标志物的研究表明，疾病临床特征的改善与血清和肝脏中丙型肝炎病毒（HCV）的减少或清除有关。使用相同方案的临床中心之间反应率的异质性强调，选择接受治疗的患者对于治疗结果与治疗方案本身同样重要，在无肝硬化且HCV RNA水平低的病例中反应更好。此外，HCV的基因型似乎对反应率也至关重要。因此，病毒学评估对于不仅评估HCV感染而且对于治疗的指征和监测都显得至关重要。
