Schalm S W
Department of Internal Medicine and Hepatogastroenterology, University Hospital Dijkzigt, Rotterdam, Netherlands.
Neth J Med. 1994 Mar;44(3):103-9.
Alpha-interferon has emerged as the most effective agent for the treatment of chronic hepatitis when active replication of virus B or D is present. Exogenous administration of human alpha-interferon, now possible through modern large-scale production methods, is associated with disappearance of virus from blood. Amelioration of liver disease occurs in 35% of patients with chronic hepatitis B (e-positive) with interferon doses of 10 MU thrice weekly for 16 weeks; after therapy persistent normalization of serum aminotransferases is observed in 30%. Improvement in liver disease has only occasionally been documented for chronic hepatitis D and for chronic hepatitis B e-minus mutant. Enhanced response rates (> 50%) may possibly be obtained by prolonged intermittent interferon therapy. Combination of interferon with another "antiviral" agent (vidarabine, acyclovir, prednisone) has not increased therapeutic efficacy. Alpha-interferon induces side-effects such as fatigue, flu-like syndrome, myalgia and changes in mood. Patients with decompensated cirrhosis are particularly prone to bacterial infection and disease exacerbation and should receive lower-than-normal doses. Interferon, when applied skillfully, induces the highly beneficial transition of active viral replication into viral latency, thereby greatly reducing infectivity, symptoms and activity of the liver disease.
当存在乙型或丁型病毒的活跃复制时，α干扰素已成为治疗慢性肝炎最有效的药物。通过现代大规模生产方法，现在可以外源性给予人α干扰素，这与血液中病毒的消失有关。对于慢性乙型肝炎（e抗原阳性）患者，使用10MU干扰素，每周三次，共16周，35%的患者肝病得到改善；治疗后，30%的患者血清转氨酶持续正常。慢性丁型肝炎和慢性乙型肝炎e抗原阴性突变型患者肝病的改善情况仅偶尔有记录。延长间歇性干扰素治疗可能会提高应答率（>50%）。干扰素与另一种“抗病毒”药物（阿糖腺苷、阿昔洛韦、泼尼松）联合使用并未提高治疗效果。α干扰素会引起疲劳、流感样综合征、肌痛和情绪变化等副作用。失代偿性肝硬化患者特别容易发生细菌感染和病情加重，应接受低于正常剂量的治疗。如果使用得当，干扰素会促使活跃的病毒复制向病毒潜伏状态发生高度有益的转变，从而大大降低感染性、症状和肝病的活动度。
