Bruch H R, Höhner U, Müller R
Medizinische Klinik, Gastroenterologie-Hepatologie, Krankenhaus Siegburg.
Praxis (Bern 1994). 1998 Oct 14;87(42):1408-12.
Treatment of acute viral hepatitis B is symptomatic, fulminant cases may require liver transplantation. In chronic hepatitis B interferon (IFN)-alpha will induce sustained response rates of 30-40%. Nucleoside analogues such as famciclovir or lamivudine appear to be promising for treatment in non-responders or cirrhotic and immunosuppressed patients. IFN-alpha may reduce the rate of chronic courses in acute hepatitis C infections. Chronic hepatitis C patients with elevated ALT activities, positive serum HCV RNA and portal or bridging fibrosis on biopsy are recommended for treatment with IFN-alpha. Sustained responses are observed in less than 20% of treated patients. Retreatment with IFN-alpha may be indicated in non-responders or in case of relapse. Combination therapy of IFN-alpha plus ribavirin may emerge as treatment of choice for patients with a relapse in the near future.
急性乙型病毒性肝炎的治疗以对症治疗为主，暴发性病例可能需要进行肝移植。在慢性乙型肝炎中，α干扰素（IFN）可使30% - 40%的患者获得持续应答。对于无应答者、肝硬化患者及免疫抑制患者，诸如泛昔洛韦或拉米夫定等核苷类似物似乎有望用于治疗。α干扰素可能会降低急性丙型肝炎感染发展为慢性病程的几率。对于谷丙转氨酶（ALT）活性升高、血清丙型肝炎病毒（HCV）RNA阳性且活检显示有门静脉或桥接纤维化的慢性丙型肝炎患者，建议使用α干扰素进行治疗。接受治疗的患者中，持续应答率不到20%。无应答者或复发患者可能需要再次使用α干扰素进行治疗。在不久的将来，α干扰素联合利巴韦林的联合疗法可能会成为复发患者的首选治疗方法。
