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干扰素治疗儿童慢性丙型肝炎的疗效。

Efficacy of interferons in treating children with chronic hepatitis C.

作者信息

Matsuoka S, Mori K, Nakano O, Yuasa Y, Taguchi Y, Hayabuchi Y, Kuroda Y

机构信息

Department of Paediatrics, University of Tokushima, School of Medicine, Japan.

出版信息

Eur J Pediatr. 1997 Sep;156(9):704-8. doi: 10.1007/s004310050694.

Abstract

UNLABELLED

Twenty-two children with chronic hepatitis serologically positive for hepatitis C virus (HCV) were treated with interferon-alpha (IFN-alpha). Liver biopsy showed chronic active hepatitis in 13 and chronic persistent hepatitis in 9 patients. A sustained clearance of HCV was observed in 8/22 children 12 months after the administration of IFN-alpha for 26 weeks, associated with normalization of HCV core antibody. Of these eight patients six had HCV genotype III and two HCV genotype II or IV. Hepatitis relapsed in seven other patients after completion of IFN-alpha with an increase in HCV core antibody titre, five with HCV genotype II, and two with HCV genotype III or IV. A second course of IFN-alpha suppressed the reactivation of HCV in all seven patients. Three of seven responders who relapsed after the first course remained negative for HCV RNA 12 months after their second course of IFN-alpha. However, the remaining four patients with HCV genotype II again relapsed after completing their second course of IFN-alpha. Seven children with the HCV genotype II resistant to IFN, including 8 weeks of IFN-beta administration, and showed no significant reduction in HCV core antibody titre.

CONCLUSION

The genotype of HCV (III) and a reduction in the core antibody titre appear to be useful parameters for predicting the response to IFN-alpha therapy.

摘要

未标注

22例丙型肝炎病毒(HCV)血清学阳性的慢性肝炎患儿接受了α干扰素(IFN-α)治疗。肝活检显示13例为慢性活动性肝炎,9例为慢性持续性肝炎。在给予IFN-α 26周后12个月,22例患儿中有8例实现了HCV的持续清除,同时HCV核心抗体恢复正常。这8例患者中,6例为HCV基因III型,2例为HCV基因II型或IV型。另外7例患者在IFN-α治疗结束后肝炎复发,HCV核心抗体滴度升高,其中5例为HCV基因II型,2例为HCV基因III型或IV型。第二疗程的IFN-α抑制了所有7例患者HCV的再次激活。在第一疗程后复发的7例有反应者中,3例在第二疗程的IFN-α治疗后12个月HCV RNA仍为阴性。然而,其余4例HCV基因II型患者在完成第二疗程的IFN-α治疗后再次复发。7例对IFN耐药的HCV基因II型患儿,包括给予8周的IFN-β治疗,HCV核心抗体滴度未见明显降低。

结论

HCV基因型(III型)以及核心抗体滴度的降低似乎是预测对IFN-α治疗反应的有用参数。

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