Lidman C, Magnius L, Norder H, Weiland O
Department of Infectious Diseases, Huddinge Hospital, Karolinska Institute, Stockholm, Sweden.
Scand J Infect Dis. 1993;25(1):133-5.
A 31-year-old male patient with an asymptomatic HIV infection but with a hepatitis B (HBV) related membraneous glomerulonephritis with nephrotic syndrome was given interferon alpha-2b subcutaneously 3 times weekly for 7.5 months. Zidovudine was added at the 10th week due to low CD4+ cell counts. Before the 6th week of treatment the patient reported a reduced need for diuretics to keep his lower limb edemas at a minimum. This response was partially sustained even after the 7.5 months interferon treatment course. The titers of HBV-DNA decreased markedly during the treatment with interferon but rose to pretreatment levels after discontinuation of the interferon treatment. The serum albumin increased but the proteinuria and hematuria were unaffected. Adverse reactions like fever, myalgias and anemia were tolerable and did not require dose reduction of either interferon or zidovudine. This treatment regimen, at least temporarily, improved the situation for the patient and can be worthwhile to try in HIV-infected patients with HBV related nephritis with nephrotic syndrome.
一名31岁男性患者，感染HIV但无症状，患有与乙型肝炎（HBV）相关的膜性肾小球肾炎并伴有肾病综合征，接受皮下注射α-2b干扰素，每周3次，共7.5个月。由于CD4+细胞计数低，在第10周加用齐多夫定。治疗第6周前，患者报告维持下肢水肿所需利尿剂减少。即使在7.5个月的干扰素治疗疗程后，这种反应仍部分持续。治疗期间，HBV-DNA滴度明显下降，但停用干扰素治疗后又升至治疗前水平。血清白蛋白增加，但蛋白尿和血尿未受影响。发热、肌痛和贫血等不良反应可耐受，不需要减少干扰素或齐多夫定的剂量。这种治疗方案至少在短期内改善了患者的状况，对于患有与HBV相关的肾病综合征性肾炎的HIV感染患者而言，值得一试。
