Teuber G, Dienes H P, Meyer Zum Büschenfelde K H, Gerken G
Department of Medicine I, Johannes Gutenberg Universität Mainz.
Z Gastroenterol. 1996 Apr;34(4):230-6.
We investigated the long-term effect of interferon-alpha treatment in patients with chronic hepatitis B with regard to the response status during treatment. 97 patients with chronic hepatitis B, including 18 patients with active cirrhosis Child A, were followed for 12-110 months (mean: 40.5 months) after interferon-alpha treatment. At the end of treatment complete response with loss of HBeAg and HBV-DNA was observed in 32 patients, partial response with loss of HBV-DNA in 30 patients and non-response with persistence of HBeAg and HBV-DNA in 35 patients. Overall, delayed virological improvement was observed in 43% of the 97 patients during follow-up. Delayed clearance of HBsAg occurred more frequently in complete responders (25%) than in partial responders (13%, P = n. s.) and non-responders (3% p = 0.0217). 39% of the partial and non-responders lost HBeAg during the follow-up period. HBsAg and HBeAg clearance rates were increased in female patients compared to males (HBsAg: 21% vs. 12%, p = n. s.; HBeAg: 47% vs. 32%, p = 0.0045). Reactivation of the disease was seen in 28% of the complete responders. In the 18 patients with active cirrhosis, short- and long-term response rates were impaired. Only, 4/18 patients had a complete response during treatment and two of these patients suffered reactivation during follow-up. One patient underwent liver transplantation and five patients died due to complications of cirrhosis. Thus, in patients without apparent cirrhosis interferon-alpha treatment has a considerable long-term effect with regard to the enhanced rate of HBsAg and HBeAg clearance during prolonged follow-up.
我们研究了α干扰素治疗慢性乙型肝炎患者的长期疗效，以及治疗期间的应答情况。97例慢性乙型肝炎患者，包括18例Child A级活动性肝硬化患者，在接受α干扰素治疗后随访12 - 110个月（平均40.5个月）。治疗结束时，32例患者出现HBeAg和HBV - DNA消失的完全应答，30例患者出现HBV - DNA消失的部分应答，35例患者出现HBeAg和HBV - DNA持续存在的无应答。总体而言，97例患者中有43%在随访期间出现延迟病毒学改善。完全应答者中HBsAg延迟清除的发生率（25%）高于部分应答者（13%，P无统计学意义）和无应答者（3%，P = 0.0217）。部分应答者和无应答者中有39%在随访期间HBeAg消失。女性患者的HBsAg和HBeAg清除率高于男性（HBsAg：21%对12%，P无统计学意义；HBeAg：47%对32%，P = 0.0045）。28%的完全应答者出现疾病复发。在18例活动性肝硬化患者中，短期和长期应答率均受损。仅4/18例患者在治疗期间出现完全应答，其中2例在随访期间复发。1例患者接受了肝移植，5例患者因肝硬化并发症死亡。因此，对于无明显肝硬化的患者，α干扰素治疗在延长的随访期间对提高HBsAg和HBeAg清除率具有显著的长期疗效。
