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影响慢性丙型肝炎患者对α干扰素治疗反应的因素。

Factors affecting treatment responses to interferon-alpha in chronic hepatitis C.

作者信息

Pawlotsky J M, Roudot-Thoraval F, Bastie A, Darthuy F, Rémiré J, Métreau J M, Zafrani E S, Duval J, Dhumeaux D

机构信息

Department of Bacteriology, Hôpital Henri Mondor, Université Paris-XII, Créteil, France.

出版信息

J Infect Dis. 1996 Jul;174(1):1-7. doi: 10.1093/infdis/174.1.1.

Abstract

Parameters have been studied to predict responses to interferon (IFN) therapy for chronic hepatitis C, but the definition of a response, the times at which responses were assessed, and the pretreatment parameters considered differ markedly from study to study. Thus, 113 patients with chronic hepatitis C were treated 3-6 months with 3 MU of IFN-alpha 2a three times a week and assessed for pretreatment parameters predictive of responses to IFN. In a multivariate analysis, a biochemical response (normal aminotransferase activity) at the end of treatment was significantly associated with low body weight, normal gamma-glutamyl transpeptidase activity, and a pretreatment hepatitis C virus (HCV) genotype other than 1. Six months after the end of treatment, a low virus burden and a lack of anti-HCV IgM core antibodies were independently associated with sustained virologic response (i.e., normal aminotransferase activity and HCV RNA negativity). Therefore, these pretreatment parameters should be taken into account when individual treatment protocols are designed.

摘要

已有多项参数用于预测慢性丙型肝炎患者对干扰素(IFN)治疗的反应,但不同研究中反应的定义、评估反应的时间以及所考虑的治疗前参数差异显著。因此,对113例慢性丙型肝炎患者进行了为期3 - 6个月的治疗,每周三次给予3 MU的α-2a干扰素,并评估预测IFN反应的治疗前参数。在多变量分析中,治疗结束时的生化反应(转氨酶活性正常)与低体重、γ-谷氨酰转肽酶活性正常以及治疗前丙型肝炎病毒(HCV)基因型非1型显著相关。治疗结束后6个月,低病毒载量和缺乏抗HCV IgM核心抗体与持续病毒学反应(即转氨酶活性正常和HCV RNA阴性)独立相关。因此,在设计个体化治疗方案时应考虑这些治疗前参数。

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