Lin R, Liddle C, Farrell G C
Department of Gastroenterology and Hepatology, University of Sydney, Westmead Hospital, N.S.W., Australia.
Gastroenterol Jpn. 1993 May;28 Suppl 5:101-3. doi: 10.1007/BF02989217.
Interferon has been shown to be effective in the treatment of chronic hepatitis C but the optimal treatment regime has not yet been defined. Studies using 3 million units (MU) of interferon thrice weekly (tiw) for 6 months have shown normalization of serum alanine aminotransferase (ALT) in about 50% of patients, but relapse occurs in at least 50% of responders after interferon is stopped. The aims of this study were to determine whether 5 MU of interferon tiw produces a higher response rate than 3 MU tiw and to examine if the higher dose results in more sustained remissions. In addition, factors that are associated with a more or less favourable response to interferon treatment were sought. Overall, 65% of patients responded and no advantage of the higher dose therapy was found, either in terms of response or relapse rate after treatment. The presence of cirrhosis on the pre-treatment liver biopsy was associated with a poor response rate to interferon and a trend towards a higher relapse rate. Risk factor for acquisition of disease was also related to likelihood of response but not relapse. We conclude that two thirds of Australian patients with chronic hepatitis C initially respond to interferon treatment. Positive predictors of response are intravenous drug use as a risk factor and histologically less severe liver disease. Relapse occurs in two thirds of all responders.
干扰素已被证明在治疗慢性丙型肝炎方面有效，但最佳治疗方案尚未确定。使用300万单位（MU）干扰素每周三次（tiw）治疗6个月的研究表明，约50%的患者血清丙氨酸氨基转移酶（ALT）恢复正常，但在停用干扰素后，至少50%的应答者会复发。本研究的目的是确定5MU干扰素tiw是否比3MU tiw产生更高的应答率，并检查更高剂量是否导致更持久的缓解。此外，还寻找了与干扰素治疗反应或多或少有利相关的因素。总体而言，65%的患者有反应，在治疗后的反应或复发率方面，未发现高剂量治疗有任何优势。治疗前肝活检存在肝硬化与对干扰素的低反应率和较高的复发率趋势相关。感染疾病的危险因素也与反应的可能性有关，但与复发无关。我们得出结论，三分之二的澳大利亚慢性丙型肝炎患者最初对干扰素治疗有反应。反应的阳性预测因素是以静脉注射毒品作为危险因素以及组织学上肝脏疾病较轻。所有应答者中有三分之二会复发。
