Morisco F, Tuccillo C, Iasevoli P, Sessa G, Brunasso G, Caporaso N
Department of Internal Medicine F. Magrassi, Second University of Naples, Italy.
Eur J Gastroenterol Hepatol. 1998 May;10(5):399-403. doi: 10.1097/00042737-199805000-00008.
To define the biochemical and virological course and IgM response to HCV-core protein in long-term responders (LTRs) during a long surveillance (5 years).
From 1989 to 1991, 98 patients (pts) with biopsy-proven chronic hepatitis C were enrolled into this study. These pts underwent human leukocyte interferon-alpha (LE-IFN alpha) therapy at the prolonged schedule (3 MU thrice weekly for 1 year).
Serum alanine-aminotransferases (ALTs) were assessed monthly during and until 1 year after treatment, then every 3 months during the observation period. Qualitative and quantitative HCV RNA and HCV IgM were measured in all pts on baseline samples and in LTRs also after treatment and every following year.
Based on serum ALT course, the pts were defined as: LTRs (14 pts), if their serum ALT levels returned to the normal range during therapy and remained so for at least 1 year afterwards; responders with relapse (RRs, 20 pts), if their serum ALT levels returned to the normal range during therapy but increased after ending treatment; and non-responders (NRs, 64 pts), if their serum ALT levels remained abnormal throughout therapy. No significant differences were seen regarding IgM anti-HCV positivity and serum ALT levels among the three groups. LTRs (12 HCV-RNA negative and two HCV-RNA positive at the end of treatment) maintained their virological status and not one of them experienced an elevation of serum ALT levels throughout the surveillance.
Patients affected by chronic hepatitis C and treated with interferon, but who did not experience a biochemical or virological relapse within the first year of follow-up would not relapse later on; thus, we are able to conclude that these subjects made a complete recovery.
确定长期应答者（LTR）在长达5年的长期监测期间对丙型肝炎病毒核心蛋白的生化、病毒学进程及IgM反应。
1989年至1991年，98例经活检证实为慢性丙型肝炎的患者纳入本研究。这些患者接受延长疗程（300万单位，每周三次，共1年）的人白细胞干扰素-α（LE-IFNα）治疗。
在治疗期间及治疗后1年内每月评估血清丙氨酸氨基转移酶（ALT），在观察期内每3个月评估一次。对所有患者的基线样本以及LTR患者治疗后及随后每年均检测定性和定量的丙型肝炎病毒RNA（HCV RNA）及HCV IgM。
根据血清ALT进程，患者被定义为：LTR（14例），若其血清ALT水平在治疗期间恢复正常范围并在之后至少持续一年保持正常；复发应答者（RR，20例），若其血清ALT水平在治疗期间恢复正常范围但在治疗结束后升高；无应答者（NR，64例），若其血清ALT水平在整个治疗过程中均保持异常。三组之间在IgM抗-HCV阳性率及血清ALT水平方面未见显著差异。LTR（治疗结束时12例HCV-RNA阴性，2例HCV-RNA阳性）维持其病毒学状态，在整个监测期间无一例血清ALT水平升高。
慢性丙型肝炎患者接受干扰素治疗，但在随访的第一年未出现生化或病毒学复发，随后也不会复发；因此，我们能够得出结论，这些患者已完全康复。
