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[丙型肝炎病毒和庚型肝炎病毒对重组干扰素α-2b治疗的反应]

[The response of the hepatitis C and hepatitis G viruses to treatment with recombinant interferon alfa-2b].

作者信息

Infante Pina D, Pich Rosal M, Sauleda Oliveras S, Tormo Carnice R, Esteban Mur J I, Esteban Mur R

机构信息

Servicio de Hepatología, Departamento de Medicina Interna, Hospital Universitario Vall d'Hebrón, Barcelona.

出版信息

An Esp Pediatr. 1998 Dec;49(6):609-14.

PMID:9972624
Abstract

OBJECTIVE

The efficacy of recombinant alfa-2b interferon therapy in C-virus (HCV) and G-virus (HGV) in children with chronic hepatitis C was evaluated.

PATIENTS AND METHODS

Fifteen patients, between 6 and 16 years of age and positive for HCV of which four were also infected with HGV, were treated with interferon (3 M three times a week for 6 months). The responders were treated for 12 months. HCV RNA, antibodies to HCV, HVC viral genome (expressed as 1000 copy equivalents of HCV genome = 1 keq), HGV RNA (RT/PCR, 5'NCR-NS5), and E2-HGV antibodies were determined before treatment and at 3 and 6 months in all patients and at 12-24 months in the responders.

RESULTS

Four HCV patients (27%) with low viral load (mean 36 keg/ml) showed good results after interferon treatment and two of them (13%) with genotypes 1b and 3 according to Simmond's classification showed a maintained response. The four HGV children also showed the same good results and the RNA was negative without sero-conversion to anti-E2 after 12 months of interferon treatment. In the post-interferon treatment period, the HGV RNA appeared again in the serum in 3 of the 4 children. In the child with a maintained response, serum conversion to anti-E2 was not detected.

CONCLUSIONS

  1. The current results, with only 13% of the patients reaching a sustained response, question the systematic treatment of all children affected with hepatitis C virus. Since the cost-benefit ratio is not yielding the expected results, such therapy may be reserved for patients with genotype other than 1b and a low level of viral genome. 2) HGV is sensitive to treatment with interferon, although the infection frequently appears again once the treatment is over.
摘要

目的

评估重组α-2b干扰素治疗慢性丙型肝炎儿童C型病毒(HCV)和G型病毒(HGV)感染的疗效。

患者与方法

15名年龄在6至16岁之间且HCV呈阳性的患者,其中4名同时感染了HGV,接受干扰素治疗(3百万单位,每周三次,共6个月)。有反应者接受12个月治疗。在所有患者治疗前、3个月和6个月时以及有反应者在12至24个月时,测定HCV RNA、抗HCV抗体、HVC病毒基因组(以1000拷贝当量的HCV基因组 = 1 keq表示)、HGV RNA(逆转录聚合酶链反应,5'非编码区 - NS5)以及E2 - HGV抗体。

结果

4名病毒载量低(平均36 keg/ml)的HCV患者(27%)在干扰素治疗后效果良好,根据西蒙兹分类,其中2名基因型为1b和3型的患者(13%)显示持续反应。4名感染HGV的儿童也有同样良好的效果,且在干扰素治疗12个月后RNA呈阴性,未出现抗E2血清转换。在干扰素治疗后的时期,4名儿童中有3名血清中HGV RNA再次出现。在有持续反应的儿童中,未检测到抗E2血清转换。

结论

1)目前的结果显示,仅有13%的患者达到持续反应,这对所有丙型肝炎病毒感染儿童进行系统性治疗提出了质疑。由于成本效益比未达到预期结果,此类治疗可能仅适用于基因型非1b且病毒基因组水平低的患者。2)HGV对干扰素治疗敏感,尽管治疗结束后感染常再次出现。

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