Dusheiko G
Royal Free Hospital and School of Medicine, London, United Kingdom.
Hepatology. 1997 Sep;26(3 Suppl 1):112S-121S. doi: 10.1002/hep.510260720.
Alpha interferons have been used widely to treat chronic hepatitis C virus infection. These include recombinant interferons, purified natural leukocyte, and lymphoblastoid interferons. Alpha interferon is administered by subcutaneous or intramuscular injection either daily or three times weekly for a period of 6 to as long as 24 months. A wide array of adverse effects of alpha interferon have been described. Several side effects such as fever, headache fatigue, arthralgias, and myalgias are common, especially with the initial injections. These early side effects of interferon are predictable and are encountered in the majority of patients. These may not require dose modification, but can be problematic for a significant proportion of patients. Other adverse events effects may require dose modification or even discontinuation of therapy in 2% to 10% of patients. Neuropsychiatric side effects such as depression and irritability can be most troublesome; their mechanisms are not well understood. Granulocytes, platelets, and red blood cell counts decrease during treatment, but the decreases are usually mild, although they can be dose limiting if cell counts are low initially. Interferon has important immunomodulatory properties, and treatment can induce autoimmune phenomena, the most frequent being autoimmune thyroiditis with either hypothyroidism or hyperthyroidism, especially in predisposed patients. Other autoimmune disease can be aggravated by interferon therapy. Severe and even life-threatening side effects of interferon occur in 0.1% to 1% of patients; these include thyroid, visual, auditory, renal, and cardiac impairment, and pulmonary interstitial fibrosis. Some of these side effects may be irreversible. Higher doses of interferon (above 5 million units three times weekly) cause higher rates of adverse events than standard doses. Contraindications to alpha interferon have been recognized.
α干扰素已被广泛用于治疗慢性丙型肝炎病毒感染。这些包括重组干扰素、纯化的天然白细胞干扰素和淋巴母细胞干扰素。α干扰素通过皮下或肌肉注射给药，每日一次或每周三次，持续6至长达24个月。α干扰素的不良反应种类繁多。几种副作用，如发热、头痛、疲劳、关节痛和肌痛很常见，尤其是在初次注射时。干扰素的这些早期副作用是可预测的，大多数患者都会出现。这些可能不需要调整剂量，但对相当一部分患者来说可能会有问题。其他不良事件在2%至10%的患者中可能需要调整剂量甚至停止治疗。神经精神方面的副作用，如抑郁和易怒，可能最麻烦；其机制尚不清楚。治疗期间粒细胞、血小板和红细胞计数会下降，但通常下降程度较轻，不过如果最初细胞计数较低，它们可能会限制剂量。干扰素具有重要的免疫调节特性，治疗可诱发自身免疫现象，最常见的是伴有甲状腺功能减退或亢进的自身免疫性甲状腺炎，尤其是在易感患者中。其他自身免疫性疾病可能会因干扰素治疗而加重。0.1%至1%的患者会出现严重甚至危及生命的干扰素副作用；这些包括甲状腺、视觉、听觉、肾脏和心脏损害，以及肺间质纤维化。其中一些副作用可能是不可逆的。较高剂量的干扰素（每周三次超过500万单位）比较标准剂量会导致更高的不良事件发生率。α干扰素的禁忌证已得到确认。
