Hoofnagle J H, Di Bisceglie A M, Waggoner J G, Park Y
Liver Diseases Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland.
Gastroenterology. 1993 Apr;104(4):1116-21. doi: 10.1016/0016-5085(93)90281-g.
The prognosis of advanced cirrhosis due to chronic hepatitis B is poor, and results of therapies, including liver transplantation, have been unsatisfactory. Little is known about the effectiveness of interferon alfa in patients with cirrhosis.
Between 1984 and 1991, 18 patients with clinically-apparent cirrhosis due to hepatitis B were treated with interferon alfa at the Clinical Center of the National Institutes of Health.
Six treated patients (33%) had a sustained loss of hepatitis B virus DNA and hepatitis B e antigen (if present initially) and decrease of amino-transferase levels into the normal or near normal range. In follow-up, these 6 patients resolved all symptoms of cirrhosis and are alive and fully active. In contrast, the 12 patients who did not have a sustained loss of hepatitis B virus have had evidence of progressive liver disease, 6 have died and 4 underwent hepatic transplantation. Side effects of interferon were common and included bacterial infections (n = 5) and exacerbations of disease (n = 9).
These findings indicate that interferon alfa is effective in selected patients with mildly decompensated cirrhosis due to hepatitis B.
慢性乙型肝炎所致晚期肝硬化的预后较差，包括肝移植在内的各种治疗方法的效果均不尽人意。关于干扰素α对肝硬化患者的疗效知之甚少。
1984年至1991年间，美国国立卫生研究院临床中心对18例临床诊断为乙型肝炎所致肝硬化的患者使用干扰素α进行治疗。
6例接受治疗的患者（33%）实现了乙肝病毒DNA和乙肝e抗原（若最初存在）的持续清除，转氨酶水平降至正常或接近正常范围。随访发现，这6例患者的所有肝硬化症状均消失，目前存活且活动自如。相比之下，12例未实现乙肝病毒持续清除的患者出现了肝病进展的迹象，6例死亡，4例接受了肝移植。干扰素的副作用很常见，包括细菌感染（5例）和病情加重（9例）。
这些发现表明，干扰素α对部分轻度失代偿性乙型肝炎肝硬化患者有效。
