Sherlock S
Department of Surgery, University of London, UK.
J Hepatol. 1995;23 Suppl 2:3-7.
Hepatitis C affects at least 200 million people worldwide. It can be followed by chronic hepatitis, cirrhosis, and primary liver cancer. Outcome assessments in controlled trials of antiviral therapy are based on serum transaminase values, serum HCV-RNA determinations, and liver biopsy scores. Patients most likely to respond to antiviral treatment are relatively young, have low serum HCV-RNA and transaminase levels, and do not have cirrhosis. Patients whose disease is caused by genotype 1b HCV isolates are unlikely to respond. Interferon alfa (3 million units [MU] three times a week for 6 months) is associated with a 50% response rate and a 50% relapse rate--an overall response rate of 25%. Increasing the duration of therapy may increase the sustained response rate. Ribavirin, given orally, may be used for patients who fail to respond to or relapse after interferon therapy. Its side effects are few. Treatment results in a fall in transaminase levels and some decrease in hepatic inflammation, but serum HCV RNA (viral titer) is unaltered. Combinations of interferon with ribavirin are giving promising results with increased sustained, complete responses.
丙型肝炎在全球至少影响2亿人。它可能继发慢性肝炎、肝硬化和原发性肝癌。抗病毒治疗对照试验中的疗效评估基于血清转氨酶值、血清HCV-RNA测定和肝活检评分。最有可能对抗病毒治疗产生反应的患者相对年轻，血清HCV-RNA和转氨酶水平较低，且没有肝硬化。由1b型HCV分离株引起疾病的患者不太可能产生反应。α干扰素（每周3次，每次300万单位[MU]，共6个月）的有效率为50%，复发率为50%，总体有效率为25%。延长治疗时间可能会提高持续有效率。口服利巴韦林可用于对干扰素治疗无反应或复发的患者。其副作用较少。治疗可使转氨酶水平下降，肝脏炎症有所减轻，但血清HCV RNA（病毒滴度）不变。干扰素与利巴韦林联合使用在提高持续、完全缓解率方面取得了令人鼓舞的结果。
