Bayraktar Y, Koseoglu T, Somner C, Kayhan B, Temizer A, Uzunalimoglu B, De Maria N, Van Thiel D H
Gastroenterology Department, Hacettepe University, School of Medicine, Ankara, Turkey.
J Viral Hepat. 1996 May;3(3):129-35. doi: 10.1111/j.1365-2893.1996.tb00003.x.
An individual's iron status may affect the response rate achieved with the use of interferon (IFN) as therapy for chronic viral hepatitis. A total of 27 patients with chronic hepatitis B viral infection, who had elevated serum ferritin levels, were randomized to receive either IFN 5 MU, three times weekly by subcutaneous injection alone (n = 14) or in combination with cycles of deferoxamine at a dose od 80 mg kg-1 per cycle (n = 13) administered over 3 consecutive days, to reduce their iron and maintain a serum ferritin level less than 250 ng ml-1. All deferoxamine-treated patients were on a low iron-containing diet. An IFN response was defined as a normalization of the serum alanine aminotransferase (ALT) level and seroconversion from hepatitis B e antigen (HBeAg) positivity to hepatitis B e antibody (HBeAb) positivity. The deferoxamine-treated group experienced a reduction in their serum ferritin level to 226 +/- 73 ng ml-1 as a result of the deferoxamine treatment. Six of the 13 (46%) deferoxamine-treated patients and two of the 14 (14%) control patients normalized their ALT levels. Seven of the 13 (54%) deferoxamine but only 14% of the IFN-treated group seroconverted to HBeAb positivity. A greater rate of histological improvement and loss of hepatitis B virus (HBV) DNA was seen in the deferoxamine-treated group. Two of the deferoxamine-treated patients were treated only once, two were treated twice, seven were treated three times and two were treated four times to achieve a ferritin level below 250 ng ml-1. Based on these data, we conclude that deferoxamine infusion enhances the rate of response to IFN in subjects with chronic hepatitis B. The precise mechanism of this phenomenon is not clear.
个体的铁状态可能会影响使用干扰素（IFN）治疗慢性病毒性肝炎时所达到的应答率。共有27例慢性乙型肝炎病毒感染且血清铁蛋白水平升高的患者，被随机分为两组，一组仅接受皮下注射IFN 5 MU，每周3次（n = 14），另一组接受IFN 5 MU皮下注射并联合去铁胺治疗，每周期剂量为80 mg/kg，连续3天给药（n = 13），以降低体内铁含量并使血清铁蛋白水平维持在低于250 ng/ml。所有接受去铁胺治疗的患者均采用低铁饮食。IFN应答定义为血清丙氨酸氨基转移酶（ALT）水平恢复正常以及从乙肝e抗原（HBeAg）阳性血清学转换为乙肝e抗体（HBeAb）阳性。去铁胺治疗组患者经去铁胺治疗后血清铁蛋白水平降至226±73 ng/ml。13例接受去铁胺治疗的患者中有6例（46%）、14例对照组患者中有2例（14%）ALT水平恢复正常。13例接受去铁胺治疗的患者中有7例（54%）血清学转换为HBeAb阳性，而IFN治疗组仅有14%血清学转换为HBeAb阳性。去铁胺治疗组在组织学改善和乙肝病毒（HBV）DNA丢失方面有更高的发生率。为使铁蛋白水平低于250 ng/ml，13例接受去铁胺治疗的患者中，2例仅接受了1次治疗，2例接受了2次治疗，7例接受了3次治疗，2例接受了4次治疗。基于这些数据，我们得出结论：去铁胺输注可提高慢性乙型肝炎患者对IFN的应答率。这一现象的确切机制尚不清楚。
