Bresci G, Parisi G, Banti S, Bertoni M
Department of Gastroenterology, USL 12, Pisa, Italy.
Eur J Med. 1993 Jun-Jul;2(6):349-52.
The aim of this study was to evaluate the efficacy of interferon therapy in patients with "active" chronic hepatitis.
A total of 115 patients with histological diagnosis of active chronic hepatitis were enrolled in the study and treated with recombinant alpha 2b-interferon at a dosage of 3 MU, 3 times a week, for a 6 month period. Patients who showed a complete normalization of serum aminotransferase levels were followed for further 12 months, in which no treatment was performed.
After 6 months of treatment, 50 (43.4%) patients showed normalized serum aminotransferase levels and among these "responders", 18 (36%) showed a persistent normalization 12 months after stopping interferon therapy. Only 7 patients at the end of the study agreed to a second liver biopsy which showed a decrease in Knodell's index and a clear-cut reduction of inflammation and lobular necrosis.
Interferon is useful for the treatment of chronic active anti-HCV positive hepatitis but the beneficial responses are often transient. Future therapeutic strategies and the development of direct assay for HCV in serum and liver are necessary to understand the real role of interferon in chronic anti-HCV positive hepatitis.
本研究旨在评估干扰素治疗“活动性”慢性肝炎患者的疗效。
共有115例经组织学诊断为活动性慢性肝炎的患者纳入本研究,接受重组α2b干扰素治疗,剂量为3 MU,每周3次,为期6个月。血清转氨酶水平完全恢复正常的患者再随访12个月,期间不进行治疗。
治疗6个月后,50例(43.4%)患者血清转氨酶水平恢复正常,在这些“应答者”中,18例(36%)在停止干扰素治疗12个月后仍持续保持正常。研究结束时只有7例患者同意进行第二次肝活检,结果显示Knodell指数下降,炎症和小叶坏死明显减轻。
干扰素对慢性活动性抗丙型肝炎病毒阳性肝炎的治疗有用,但有益反应往往是短暂的。未来需要进一步的治疗策略以及开发血清和肝脏中丙型肝炎病毒的直接检测方法,以了解干扰素在慢性抗丙型肝炎病毒阳性肝炎中的真正作用。