Barbera C, Bortolotti F, Crivellaro C, Coscia A, Zancan L, Cadrobbi P, Nebbia G, Pillan M N, Lepore L, Parrella T
Institute of Pediatric Studies, Turin University, Italy.
Hepatology. 1994 Aug;20(2):287-90.
We conducted a prospective controlled study of the efficacy of recombinant interferon-alpha 2a in 77 children (44 boys, 33 girls, mean age 8 yr) with chronic hepatitis B. All patients had seropositive results for HBeAg and hepatitis B virus DNA; 52 had chronic persistent or nonspecific reactive hepatitis, and 25 had mild active hepatitis. Twenty-one children (group 1) received recombinant interferon-alpha 2a 7.5 megaunits/m2 three times weekly for 6 mo, 19 children (group 2) received megaunits/m2 on the same schedule and 37 (group 3) remained untreated. At 6 mo, HBe antigen-to-antibody seroconversion associated with biochemical remission was seen in 24% of patients in group 1, 5% in group 2 and 3% in group 3 (p < 0.05 vs. group 1). At 18 mo, seroconversion rates were 30% in group 1, 21% in group 2 and 13.5% in group 3. These results suggest that a course of recombinant interferon-alpha 2a accelerates HBeAg-HBe antibody seroconversion in children. High baseline ALT levels were sensitive predictors of seroconversion in both treated and untreated patients. In contrast, baseline IgM HBc antibody levels influenced the rate of anti-HBe seroconversion only in untreated patients. These findings suggest that, in children as well as in adults, recombinant interferon-alpha 2a favors the clearance of hepatitis B virus replication, enhancing the host antiviral immunoresponse.
我们对77例慢性乙型肝炎儿童（44例男孩，33例女孩，平均年龄8岁）进行了一项关于重组干扰素α-2a疗效的前瞻性对照研究。所有患者HBeAg和乙肝病毒DNA血清学检测均为阳性；52例为慢性持续性或非特异性反应性肝炎，25例为轻度活动性肝炎。21名儿童（第1组）接受重组干扰素α-2a 7.5百万单位/m²，每周3次，共6个月；19名儿童（第2组）按相同方案接受百万单位/m²治疗，37名儿童（第3组）未接受治疗。6个月时，第1组24%的患者出现与生化缓解相关的HBe抗原到抗体血清学转换，第2组为5%，第3组为3%（与第1组相比，p<0.05）。18个月时，第1组血清学转换率为30%，第2组为21%，第3组为13.5%。这些结果表明，重组干扰素α-2a疗程可加速儿童HBeAg-HBe抗体血清学转换。高基线ALT水平是治疗和未治疗患者血清学转换的敏感预测指标。相比之下，基线IgM HBc抗体水平仅影响未治疗患者的抗-HBe血清学转换率。这些发现表明，在儿童和成人中，重组干扰素α-2a有利于清除乙肝病毒复制，增强宿主抗病毒免疫反应。
