Hepatology. 1997 Sep;26(3 Suppl 1):2S-10S. doi: 10.1002/hep.510260701.
The objective of this article is to provide health care providers, patients, and the general public with a responsible assessment of current available methods to diagnose, treat, and manage hepatitis C. A non-Federal, non-advocate, 12-member panel representing the fields of general internal medicine, hepatology, gastroenterology, infectious diseases, medical ethics, transfusion medicine, epidemiology, biostatistics, and the public participated. In addition, 25 experts from these same fields presented data to the panel and a conference audience of 1,600. The literature was searched through Medline, and an extensive bibliography of references was provided to the panel and the conference audience. Experts prepared abstracts with relevant citations from the literature. Scientific evidence was given precedence over clinical anecdotal experience. The panel, answering predefined questions, developed their conclusions based on the scientific evidence presented in open forum and the scientific literature. The panel composed a draft statement that was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after conference. Hepatitis C is a common infection with variable course that can lead to chronic hepatitis, cirrhosis, and hepatocellular carcinoma. The course of illness may be adversely affected by various factors, especially alcohol consumption. Therefore, more than one drink per day is strongly discouraged in patients with hepatitis C, and abstinence from alcohol is recommended. Initial therapy with interferon alfa (or equivalent) should be 3 million units three times per week for 12 months. Patients not responding to therapy after 3 months should not receive further treatment with interferon alone, but should be considered for combination therapy of interferon and ribavirin or for enrollment in investigational studies. Individuals infected with the hepatitis C virus (HCV) should not donate blood, organs, tissues, or semen. Safe sexual practices, including the use of latex condoms, is strongly encouraged for individuals with multiple sexual partners. Expansion of needle exchange programs should be considered in an effort to reduce the rate of transmission of hepatitis C among injection drug users.
本文的目的是为医疗保健提供者、患者及普通公众提供对当前诊断、治疗和管理丙型肝炎的可用方法的负责任评估。一个由普通内科、肝病学、胃肠病学、传染病学、医学伦理学、输血医学、流行病学、生物统计学领域以及公众代表组成的非联邦、无倡导倾向的12人小组参与其中。此外，来自这些相同领域的25位专家向该小组和1600名参会听众提供了数据。通过医学文献数据库（Medline）检索文献，并向该小组和参会听众提供了一份广泛的参考文献目录。专家们准备了带有文献相关引用的摘要。科学证据优先于临床轶事经验。该小组在回答预先设定的问题时，根据公开论坛上呈现的科学证据和科学文献得出结论。该小组撰写了一份声明草案，全文宣读后分发给专家和听众征求意见。此后，该小组解决了相互冲突的建议，并在会议结束时发布了一份修订声明。会议结束后的几周内，该小组完成了最终修订。丙型肝炎是一种常见感染，病程多变，可导致慢性肝炎、肝硬化和肝细胞癌。疾病进程可能受到多种因素的不利影响，尤其是饮酒。因此，强烈不建议丙型肝炎患者每天饮酒超过一杯，建议戒酒。初始使用干扰素α（或等效药物）治疗应为每周三次，每次300万单位，持续12个月。治疗3个月后无反应的患者不应仅接受干扰素进一步治疗，而应考虑干扰素与利巴韦林联合治疗或参加研究性试验。感染丙型肝炎病毒（HCV）的个体不应献血、器官、组织或精液。对于有多个性伴侣的个体，强烈鼓励采取安全性行为，包括使用乳胶避孕套。应考虑扩大针头交换项目，以努力降低丙型肝炎在注射吸毒者中的传播率。
