Larghi A, Tagger A, Crosignani A, Ribero M L, Bruno S, Portera G, Battezzati P M, Maggioni M, Fasola M, Zuin M, Podda M
Department of Internal Medicine, Ospedale San Paolo, Milan, Italy.
J Med Virol. 1998 May;55(1):7-11.
Whether sustained biochemical response and absence of serum HCV RNA in the 6-12 months following suspension of interferon-alpha (IFN-alpha) therapy reflect definitive viral clearance in patients with chronic hepatitis C virus (HCV) infection is controversial. To obtain more information on this topic, HCV RNA was sought in both liver and serum samples of 25 long-term responders who were followed for a median period of 39 months (range 21-79) after discontinuation of IFN-alpha. Liver biopsy was undertaken before and 6 to 12 months after IFN-alpha withdrawal. Liver and serum HCV RNA were tested by a nested polymerase chain reaction. Twenty-two patients (88%) tested negative for both liver and serum HCV RNA, two patients had detectable HCV RNA in both liver and serum, and one patient showed persistent HCV RNA only in the liver. Post-treatment liver histology improved markedly in all patients, including those with viral persistence. During further follow-up, biochemical remission was maintained in all patients except one in whom both serum and liver specimens remained HCV RNA positive. The data indicate that the large majority of long-term responders test negative for HCV RNA in the liver, which suggests definitive eradication of HCV RNA infection.
在慢性丙型肝炎病毒（HCV）感染患者中，停止使用α干扰素（IFN-α）治疗后的6 - 12个月内持续的生化反应及血清HCV RNA的缺失是否反映病毒被彻底清除存在争议。为了获取关于该主题的更多信息，我们对25名长期缓解者的肝脏和血清样本进行了HCV RNA检测，这些患者在停用IFN-α后接受了为期39个月（范围21 - 79个月）的中位随访。在停用IFN-α之前以及之后6至12个月进行了肝活检。通过巢式聚合酶链反应检测肝脏和血清中的HCV RNA。22名患者（88%）的肝脏和血清HCV RNA检测均为阴性，2名患者的肝脏和血清中均可检测到HCV RNA，1名患者仅在肝脏中显示持续的HCV RNA。所有患者，包括病毒持续存在的患者，治疗后的肝脏组织学均有明显改善。在进一步随访期间，除1名患者血清和肝脏标本HCV RNA均为阳性外，所有患者均维持生化缓解。数据表明，绝大多数长期缓解者肝脏中的HCV RNA检测为阴性，这提示HCV RNA感染被彻底根除。
