Coelho H S, Soares J A, Carvalho B B, Santos M A, Soldan M
Serviço de Clínica Médica, Universidade Federal do Rio de Janeiro.
Rev Assoc Med Bras (1992). 1995 Sep-Oct;41(5):313-7.
Chronic hepatitis C usually progresses to cirrhosis and hepatocarcinoma. Treatment with antiviral drugs is indicated attempting to modify the evolution of the disease.
To evaluate the treatment of chronic hepatitis C or post-hepatitis C cirrhosis with interferon-a-R (IFN) and to identify the factors associated with good therapeutic result.
Thirty eight patients with chronic hepatitis C or post-hepatitis C cirrhosis were treated with 2.5 or 3.0 MU of IFN three times a week for 6 to 12 months. We considered as a complete and sustained response when ALT and AST were normal for a 6 months period after finishing treatment. We considered complete response with relapse those in whom elevation of the enzymes was detected after drug suspension.
There was normalization of ALT and AST in 17 out of 38 patients (44%). In this group, 9 out of 17 presented a complete and sustained response and in 8 out of 17 there was elevation of the enzymes after drug interruption. There was a trend of better response to interferon in patients below 40 years of age and in those with chronic active hepatitis. The most frequent side effects were fever (80%), myalgia (60%), asthenia (50%), headache (40%), and arthralgia (36%).
Treatment with interferon showed a satisfactory and sustained response in 23% of the subjects, with better results in young patients and without cirrhosis.
慢性丙型肝炎通常会发展为肝硬化和肝癌。抗病毒药物治疗旨在改变疾病的发展进程。
评估用α-R干扰素（IFN）治疗慢性丙型肝炎或丙型肝炎后肝硬化，并确定与良好治疗效果相关的因素。
38例慢性丙型肝炎或丙型肝炎后肝硬化患者接受2.5或3.0百万单位的IFN治疗，每周3次，持续6至12个月。治疗结束后6个月内ALT和AST正常则视为完全持续缓解。药物停用后酶升高的患者视为完全缓解但复发。
38例患者中有17例（44%）ALT和AST恢复正常。在该组中，17例中有9例呈现完全持续缓解，17例中有8例在药物中断后酶升高。40岁以下患者和慢性活动性肝炎患者对干扰素的反应有更好的趋势。最常见的副作用是发热（80%）、肌痛（60%）、乏力（50%）、头痛（40%）和关节痛（36%）。
干扰素治疗在23%的受试者中显示出令人满意的持续反应，年轻患者和无肝硬化患者效果更好。
