Marques A R, Lau D T, McKenzie R, Straus S E, Hoofnagle J H
Laboratory of Clinical Investigation, National Institute of Allergy andInfectious disease, National Institutes of Health, Bethesda, MD, USA.
J Infect Dis. 1998 Nov;178(5):1483-7. doi: 10.1086/314430.
Interferon-alpha (IFN-alpha) treatment results in long-term remissions in only 25%-40% of patients with chronic hepatitis B virus (HBV) infection. Famciclovir, the oral prodrug of penciclovir, inhibits HBV DNA replication. Five adults with chronic HBV infection in whom previous IFN-alpha therapy had failed were treated in a pilot study of overlapping IFN-alpha and famciclovir therapy totaling 20 weeks. HBV DNA levels decreased by 0.9 log units during the initial 4-week period of famciclovir alone, followed by a further decrease of 1.8 logs during the middle 12-week period of combination therapy. HBV DNA rose by 0.9 log during the final 4-week period of IFN-alpha alone. Two patients cleared HBV DNA, and their liver disease improved by clinical and histologic criteria. The combination of famciclovir and IFN-alpha appeared to be at least additive in suppressing HBV DNA. Efficacy trials of combination therapy with famciclovir and IFN-alpha are warranted.
α干扰素（IFN-α）治疗仅能使25% - 40%的慢性乙型肝炎病毒（HBV）感染患者获得长期缓解。喷昔洛韦的口服前体药物泛昔洛韦可抑制HBV DNA复制。在一项为期20周的α干扰素与泛昔洛韦联合治疗的初步研究中，对5例先前α干扰素治疗失败的慢性HBV感染成人患者进行了治疗。仅使用泛昔洛韦的最初4周期间，HBV DNA水平下降了0.9个对数单位，随后在联合治疗的中间12周期间又进一步下降了1.8个对数。仅使用α干扰素的最后4周期间，HBV DNA上升了0.9个对数。2例患者的HBV DNA清除，且根据临床和组织学标准，其肝病有所改善。泛昔洛韦与α干扰素联合使用在抑制HBV DNA方面似乎至少具有相加作用。有必要对泛昔洛韦与α干扰素联合治疗进行疗效试验。
