Ferenci P
Department of Gastroenterology and Hepatology, University of Vienna, Austria.
Gut. 1993;34(2 Suppl):S69-73. doi: 10.1136/gut.34.2_suppl.s69.
Interferon is currently considered to be the only accepted effective treatment for chronic viral hepatitis. A history of the treatment of chronic hepatitis B and C before the use of interferon is presented here. Hepatitis B virus does not seem to be directly cytopathic and the disease is known to be modulated largely by the host's immune response. Experience with immunosuppressant and immunostimulant drugs and a wide variety of antiviral agents, however, has indicated that none of these are of any benefit in patients with chronic hepatitis B, with the possible exception of adenine arabinoside. In view of the much more recent identification of the hepatitis C virus, studies of therapy for chronic hepatitis C are inevitably less extensive. A pilot study using acyclovir in patients with chronic non-A, non-B hepatitis did not show any benefit, although the treatment period may have been too short for the results to be conclusive. The only agent other than alpha interferon to be tried in chronic hepatitis C is ribavirin, which may have some activity. Many of the agents studied in chronic hepatitis B should also be investigated for the treatment of patients with chronic hepatitis C.
干扰素目前被认为是慢性病毒性肝炎唯一被认可的有效治疗方法。本文介绍了在使用干扰素之前慢性乙型和丙型肝炎的治疗史。乙肝病毒似乎并非直接致细胞病变，已知该疾病很大程度上受宿主免疫反应调节。然而，免疫抑制剂、免疫刺激剂药物以及多种抗病毒药物的使用经验表明，除了阿糖腺苷可能是个例外，这些药物对慢性乙型肝炎患者均无益处。鉴于丙型肝炎病毒的发现时间更近，慢性丙型肝炎的治疗研究不可避免地不够广泛。一项在慢性非甲非乙型肝炎患者中使用阿昔洛韦的初步研究未显示出任何益处，尽管治疗期可能过短，结果尚无定论。除α干扰素外，唯一在慢性丙型肝炎中进行试验的药物是利巴韦林，它可能具有一定活性。许多在慢性乙型肝炎中研究过的药物也应针对慢性丙型肝炎患者进行研究。
