Wong D K, Cheung A M, O'Rourke K, Naylor C D, Detsky A S, Heathcote J
Toronto Hospital, Ontario.
Ann Intern Med. 1993 Aug 15;119(4):312-23. doi: 10.7326/0003-4819-119-4-199308150-00011.
To determine whether alpha-interferon is effective in terminating viral replication and in eradicating the carrier state in patients with chronic hepatitis B virus (HBV) infection.
Randomized controlled studies published in the English literature between January 1966 and June 1992 were identified through a MEDLINE computer search.
Fifteen randomized controlled studies with a total of 837 adult chronic HBV carriers who were positive for hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) were identified. Studies were included if patients were treated for at least 3 months and followed for at least 6 months after cessation of therapy.
Overall, the loss of HBsAg occurred 6% more often in interferon-treated patients than the natural seroconversion seen in controls (7.8% compared with 1.8%, P = 0.001), and the loss of viral replication occurred approximately 20% more often in treated patients than in controls (33% compared with 12% for loss of HBeAg and 37% compared with 17% for the loss of HBV DNA, P = 0.0001) if patients received interferon for 3 to 6 months and were followed for 6 to 12 months. Interferon also had a significant treatment effect on the development of antibodies to HBsAg (anti-HBs), antibodies to HBeAg (anti-HBe), and on the normalization of alanine aminotransferase levels.
Alpha-interferon is effective in terminating viral replication and in eradicating the carrier state in patients with chronic HBV infection who are HBeAg positive when these patients are treated for 3 to 6 months and followed for 6 to 12 months after cessation of therapy. Follow-up studies are required to determine whether interferon reduces the risk for developing cirrhosis or hepatocellular carcinoma.
确定α干扰素在终止慢性乙型肝炎病毒（HBV）感染患者的病毒复制及消除携带状态方面是否有效。
通过医学在线（MEDLINE）计算机检索，识别1966年1月至1992年6月间发表在英文文献中的随机对照研究。
确定了15项随机对照研究，共有837名成年慢性HBV携带者，这些携带者乙肝表面抗原（HBsAg）和乙肝e抗原（HBeAg）呈阳性。如果患者接受治疗至少3个月且在治疗停止后随访至少6个月，则纳入研究。
总体而言，接受干扰素治疗的患者中HBsAg消失的发生率比对照组自然血清学转换高6%（分别为7.8%和1.8%，P = 0.001），并且如果患者接受3至6个月的干扰素治疗并随访6至12个月，治疗患者中病毒复制的消失发生率比对照组高约20%（HBeAg消失分别为33%和12%，HBV DNA消失分别为37%和17%，P = 0.0001）。干扰素对乙肝表面抗体（抗-HBs）、乙肝e抗体（抗-HBe）的产生以及丙氨酸转氨酶水平的正常化也有显著治疗效果。
对于HBeAg阳性的慢性HBV感染患者，当接受3至6个月的干扰素治疗并在治疗停止后随访6至12个月时，α干扰素在终止病毒复制及消除携带状态方面有效。需要进行随访研究以确定干扰素是否降低发生肝硬化或肝细胞癌的风险。
