聚乙二醇化干扰素α-2a 联合利巴韦林治疗慢性丙型肝炎合并甲状腺功能紊乱一例

聚乙二醇化干扰素（PegIFN）α-2a 联合利巴韦林治疗慢性丙型肝炎过程中,IFN α治疗可通过自身免疫和非自身免疫机制导致甲状腺功能异常。药物可以控制的甲状腺功能低下或亢进并非是干扰素应用的绝对禁忌症。本文介绍一例PegIFNα-2a 联合利巴韦林治疗慢性丙型肝炎中发生复杂甲状腺功能紊乱,在对症治疗、密切监测情况下成功完成干扰素疗程并获得持续病毒学应答的典型病例。     

α-2b干扰素联合阿昔洛韦联合治疗慢性乙型肝炎的疗效观察

目的:探讨α-2b干扰素联合阿昔洛韦治疗慢性乙肝的疗效和安全性。方法:把130例慢性乙肝患者随机分为3组,分别予以干扰素、阿昔洛韦、干扰素联合阿昔洛韦治疗,观察三组不同治疗方法对HBeAg、抗-HBe、HBV-DNA、ALT/AST的影响。结果:三组中,联合治疗组HBeAg转阴例数、抗-HBe转阳例数、ALT复常率、AST复常率较其他两组均有显著提高(P<0.05)。结论:α-2b干扰素联合应用阿昔洛韦治疗慢乙肝疗效好,副作用少,且价格普遍低于国外产品,更适合中国慢乙肝患者。     

聚乙二醇干扰素α-2b治疗HBeAg阴性和阳性慢性乙型肝炎疗效分析

HBeAg阴性与HBeAg阳性CHB在流行病学、发病机制、自然病程、预后和治疗等方面都截然不同[1-2].本研究旨在探讨聚乙二醇干扰素α-2b(Peg IFNα-2b)在HBeAg阴性和HBeAg阳性CHB抗病毒治疗中的差异,同时评估影响应答的相关因素. 1 资料与方法 1.1 研究对象选取2007年1月至2009年6月在杭州市第六人民医院用PegIFNα-2b治疗的88例CHB患者,其中HBeAg阴性31例,HBeAg阳性57例.PegIFNα-2b的用法:1～ 1.5 μg/kg,1次/周,皮下注射,连续48周,治疗期间不使用其他抗病毒药物及保肝药物.所选病例均符合《慢性乙型肝炎防治指南(2010年版)》[3]中IFN治疗的适应证.所有患者均签署知情同意书,治疗方案经医院伦理委员会批准.     

聚乙二醇化干扰素α-2b联合核苷（酸）类似物治疗低水平乙型肝炎病毒表面抗原慢性乙型肝炎患者的临床疗效及影响因素

目的评估聚乙二醇化干扰素α-2b（PegIFNα-2b）联合核苷（酸）类似物（NAs）治疗低水平乙型肝炎病毒表面抗原（HBsAg）慢性乙型肝炎（CHB）患者的临床疗效及影响因素分析。 方法本研究为前瞻性、非随机对照的真实世界研究,选取2018年1月至2020年5月东部战区总医院收治的使用NAs治疗1年以上,血清HBsAg ≤ 1 500 IU/ml、HBV DNA < 50 IU/ml的CHB患者,于原NAs治疗基础上联合PegIFNα-2b治疗,收集患者治疗0周、12周、24周、36周及48周丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、HBV血清标志物以及HBV DNA定量等。根据停止注射PegIFNα-2b时HBsAg是否阴转,分为治愈组（13例）和未愈组（32例）,运用广义估计方程比较两组患者HBsAg、ALT和AST水平;多因素Logistic回归模型分析HBsAg清除影响因素并绘制受试者工作特征曲线（ROC）,评估相关影响因素对HBsAg清除的预测价值。 结果共纳入CHB患者45例,完成PegIFNα-2b治疗48周患者共21例,其中临床治愈10例（治愈率为47.6%）;提前终止PegIFNα-2b治疗患者共24例,其中临床治愈3例（治愈率为12.5%）。治愈组和未愈组患者HBsAg定量较基线水平均显著下降（Z =－2.201、P = 0.028;Z = －3.17、P = 0.011）。入组48周时,治愈组患者ALT水平与基线差异无统计学意义（Z =－1.412、P = 0.158）;AST水平与基线差异有统计学意义（Z =－2.90、P = 0.004）。未愈组患者ALT和AST水平与基线差异均无统计学意义（Z =－1.97、P = 0.122,Z = －1.05、P = 0.421）。广义估计方程分析组间比较结果显示,调整年龄及性别后,两组患者在入组48周时,ALT和AST水平差异无统计学意义（χ² = 0.837、P = 0.36,χ² = 0.005、P = 0.945）,而HBsAg差异具有显著统计学意义（χ² = 24.161、P < 0.001）。多因素Logistic回归分析显示,基线HBsAg（OR = 0.073、95%CI：0.007~0.803、P = 0.032）,年龄（OR = 0.883、95%CI：0.781~0.998、P = 0.047）,PegIFNα-2b使用疗程（OR = 1.027、95%CI：1.001~1.053、P = 0.038）均为影响48周HBsAg清除的因素。基线HBsAg、年龄联合PegIFNα-2b疗程对HBsAg清除预测的ROC曲线面积为0.978（95%CI：0.883~0.993）,敏感性和特异性分别为96.44%和88.95%。 结论PegIFNα-2b联合NAs对低水平HBeAg CHB患者具有较好的临床疗效。基线HBsAg、年龄联合PegIFNα-2b疗程对48周HBsAg清除具有一定预测价值。     

咪喹莫特乳膏联合重组人干扰素α-2b治疗尖锐湿疣的效果

目的 探究咪喹莫特乳膏联合重组人干扰素α-2b在治疗尖锐湿疣中的作用。方法 选取2020年4 月-2021年3月我院收治46例的尖锐湿疣患者作为研究对象,按照随机数字表法分为对比组和研究组,各23 例。对比组予以咪喹莫特乳膏治疗,研究组予以咪喹莫特乳膏联合重组人干扰素α-2b治疗,比较两组临 床疗效、复发率、免疫细胞变化以及药物不良反应发生情况。结果 研究组治疗总有效率为100.00%,高于 对比组的78.26%,差异有统计学意义（P＜0.05）;研究组复发率为0,低于对比组的30.43%,差异有统计 学意义（P＜0.05）;两组治疗后T淋巴细胞、T淋巴细胞糖蛋白、抑制性t细胞指标均优于治疗前,且研究 组优于对比组,差异有统计学意义（P＜0.05）;研究组药物不良反应发生率为0,低于对比组17.39%,差 异有统计学意义（P＜0.05）。结论 咪喹莫特乳膏联合重组人干扰素α-2b应用于尖锐湿疣患者中,治疗效 果确切,复发率低,保证了患者免疫细胞的正常运行,且具有较高的安全性,值得临床应用。     

重组人干扰素α-2b与阿昔洛韦片联用治疗带状疱疹54例

笔者于2002年2月-2004年4月在门诊应用重组人干扰素α-2b(商品名：利分能，哈药集团生物工程有限公司生产)肌肉注射与阿昔洛韦片(丽珠集团丽珠制药厂生产)口服联用治疗带状疱疹54例，取得较为满意疗效，现将结果报告如下。     

LEEP刀联合重组人干扰素α-2b栓治疗慢性宫颈炎的临床研究

目的：研究LEEP刀联合重组人干扰素α-2b栓对慢性宫颈炎的治疗效果分析。方法选取2009年1月-2012年6月共358例于我院就诊的慢性宫颈炎的患者,将其随机分为研究组和对照组,其中对照组采用LEEP刀,研究组采用重组人干扰素α-2b栓联合LEEP刀宫颈锥形切除术,对比两组患者术后阴道分泌物情况、症状改善及疗效。结果采用LEEP刀联合重组人干扰素α-2b栓的研究组患者的阴道流液量明显少于采用LEEP刀的对照组患者,而阴道流血量无明显差异。研究组症状改善与疗效均明显优于对照组,且均具有统计学意义（P〈0.05）。结论 LEEP刀联合重组人干扰素α-2b栓可减少术后不良反应,提高手术的治愈率,值得临床推广。     

重组人干扰素α-2b凝胶联合电离子治疗扁平疣疗效观察

目的：观察重组人干扰素α-2b凝胶联合电离子治疗扁平疣的疗效。方法：将92例扁平疣患者随机分为两组,治疗组：46例,用电离子破坏疣体表面后,重组人干扰素α-2b凝胶早晚各外涂一次于疣体表面;对照组：46例,单用重组人干扰素α-2b凝胶外涂。结果：治疗组患者治愈率为71.74%,有效率为91.3%;对照组治愈率为23.91%,有效率为56.52%。两组在治愈率及有效率上均有显著性差异。结论：重组人干扰素α-2b凝胶联合电离子术治疗扁平疣在疗效上明显优于单用重组人干扰素α-2b凝胶治疗。     

人干扰素α-2b基因重组卡介苗的构建与鉴定

目的 构建能自动分泌表达人干扰素α-2b(IFNα-2b)的重组卡介苗(rBCG-IFNα-2b)菌株,并对其进行鉴定.方法 分别从人外周血和BCG基因组中提取DNA,聚合酶联反应(PCR)扩增人IFNα-2b基因和BCGAg85B信号肽基因,将该两片段插入质粒pMV261,构建分泌型卡介苗穿梭表达载体pMV261-Ag85B-IFNα-2b.电穿孔将该载体导入BCG中,构建rBCG-IFNα-2b.分别用PCR扩增和Western blot检测rBCG-IFNα-2b中人IFNα-2b基因和蛋白的表达情况,酶联免疫吸附(ELISA)检测rBCG-IFNα-2b培养上清中IFNα-2b蛋白的表达情况.结果 采用酶切、PCR扩增及DNA测序对pMV261-Ag85B-IFNα-2b进行鉴定,结果 显示BCG Ag85B信号肽片段和人IFNα-2b片段与文献结果 一致,连接方向正确.以rBCG-IFNα-2b DNA为模板、IFNα-2b引物进行PCR扩增后得到与理论上大小相同的扩增片段,Western blot显示rBCG-IFNα-2b的培养上清和菌体中均可检测到IFNα-2b蛋白的表达,且培养上清中蛋白的表达量明显多于菌体,ELISA法可检测到培养上清中有高表达的IFNα-2b蛋白(301.45 pg/ml).结论 成功构建了能自动分泌表达人IFNα-2b的新型重组卡介苗菌株rBCG-IFNα-2b,为进一步研究其免疫活性和抗膀胱肿瘤疗效奠定了基础.     

重组人干扰素α-2b治疗肛门生殖器疱疹的临床观察

为观察重组人干扰素α-2b肌肉注射治疗肛门生殖器疱疹的临床疗效,对40例肛门生殖器疱疹采用重组人干扰素α-2b300万U肌肉注射治疗（治疗组）,隔日1次;30例肛门生殖器疱疹患者口服阿昔洛韦治疗（对照组）,200mg／次,5次／d;并对疗效进行对比观察。结果显示,治疗组治疗后年复发次数下降58．5％,明显优于对照组（18．5％）,P〈0．01。治疗组IL-4、IL-10含量下降,IL-12、IL-18含量上升;对照组无明显变化。结果表明,重组人干扰素α-2b肌肉注射治疗肛门生殖器疱疹复发率低,可调节机体免疫功能。     

Treatment of patients with recurrent hepatitis C after liver transplantation with peginterferon alfa-2B plus ribavirin

BACKGROUND: Recurrent hepatitis C virus (HCV) after liver transplantation (OLT) is a major cause of graft loss in HCV-positive patients. In this study, we evaluated the efficacy and safety of pegylated interferon alfa-2b (peginterferon) and ribavirin treatment for recurrent HCV after OLT and analyzed the influence of antiviral treatment on the histological course of recurrent hepatitis. METHODS: Twenty-five patients with recurrent HCV (genotype 1 n=20 and 2-4 n=5) received peginterferon (1 mg/kg/weekly) and ribavirin (600 mg) for 48 weeks. Viral load prior to treatment was below 1,000,000 (IU/ml) in 11 of 25 patients. Sustained antiviral response was defined as undetectable HCV-RNA in serum 6 months after stopping of therapy. All patients underwent liver biopsy prior to treatment and after 72 weeks. RESULTS: Seventeen of 25 patients became HCV-RNA-negative after treatment (68%). Sustained virologic response (SVR) was achieved in 9/25 (36%) patients. Liver specimen showed increase of fibrosis from 1.7 to 2.0 within 72 weeks. Side effects like neutropenia (60%) and anemia (36%) were treated with G-CSF, erythropoietin, and dose reduction of peginterferon and ribavirin. CONCLUSIONS: The use of peginterferon is safe and effective in patients with recurrent HCV. Treatment of side effects, especially neutropenia or anemia, helped to maintain antiviral therapy. Despite a viral response of 68% during treatment, the patients showed further progress of recurrent hepatitis in liver specimen.     

Interferon-{alpha}2b treatment of chronic hepatitis C in haemodialysis patients

Nineteen haemodialysis (HD) patients with chronic hepatitisC were treated with interferonalpha2b (IFN-) at a dose of 3or 1 MU thrice weekly for 6 months and were followed-up foranother 14 months without treatment. Six patients discontinuedtreatment because they either presented severe side-effectsto IFN- or had complications of their primary disease. Levelsof AST and ALT were within normal limits on the 2nd month oftreatment and remained so throughout the treatment and the follow-upperiod in all patients except one who showed an elevation oftransaminase levels 2 months after the end of treatment. SerumHCVRNA became negative in 10/13 patients at the end of treatmentand was negative in all patients on the 6th month and in 12/13patients on the 14th month during the follow-up period. Levelsof 2'5' oligosynthetase were increased significantly on the2nd and 4th month of treatment and returned to pretreatmentvalues the 2nd month after treatment. These findings demonstratethat haemodialysis patients with chronic hepatitis C respondwell to interferon treatment and that a long-term response isachieved in a high proportion of patients.     

Combination of interferon alfa-2b and ribavirin in liver transplant recipients with histological recurrent hepatitis C

Recurrent hepatitis C virus (HCV) infection is an important cause of fibrosis and cirrhosis after liver transplantation (LT), with histological recurrence developing in at least 50% of patients within the first year. The aim of this study is to assess the safety and efficacy of interferon alfa-2b plus ribavirin in treating histological recurrent HCV after LT. Since 1998, patients with HCV with significant histological recurrence (fibrosis ≥ 3 and/or histological activity index ≥ 5) or progressive cholestatic disease after LT were treated with interferon alfa-2b (3 million units subcutaneously three times weekly) plus ribavirin (800 to 1,000 mg/d) for 12 months. Immunosuppression was tapered to cyclosporine/FK506 monotherapy. HCV RNA was assessed at entry, week 24, end of treatment, and 6 months after therapy. The primary end point was loss of HCV RNA 6 months after therapy, whereas the secondary end point was histological response. Fifty-four patients met criteria for treatment and have completed follow-up. Patients were mainly men (71% men; mean age, 51 ± 5 years) with genotype 1 infection (88%) and high viral load (mean HCV RNA, 38 ± 9 mEq/mL). Dose modification was required in 72% of patients because of cytopenia or side effects. Intent-to-treat analysis showed that serum HCV RNA was undetectable in 19 patients (35%) week 24, 21 patients (38%) week 48, and 16 patients (30%) at the 6-month follow-up. Paired liver biopsy results (before and within 6 months after treatment) were available for 35 patients. Patients who achieved viral eradication had no significant progression of fibrosis after 1 year of therapy. In summary, combination therapy is a reasonable antiviral option for recurrent HCV infection for established post-LT hepatitis and appears to prevent histological progression of disease if viral eradication is successful. (Liver Transpl 2002;8:1000-1006.)     

Pilot study of pegylated interferon alfa-2b and ribavirin for recurrent hepatitis C after liver transplantation

Recurrent hepatitis C is often treated with an interferon and ribavirin combination therapy, but the results have been disappointing. Given the promising results reported with pegylated interferon and ribavirin for hepatitis C, we were interested in evaluating the effectiveness of this treatment in liver transplant recipients with recurrent hepatitis C (HCV). METHODS: Between November 2001 and September 2002, patients with recurrent HCV were screened to determine if they were eligible for treatment. Liver function tests, HCV-RNA, and liver biopsies were performed on all patients prior to treatment. HCV-RNA was repeated at 3 months, the end of treatment (EOT), and 6 months after EOT for patients who were HCV-RNA negative at EOT. Patients were prospectively followed after starting weekly pegylated interferon alfa-2b 1.5 mcg/kg per week and ribavirin 800 mg per day (Schering-Plough, Kenilworth, NJ, USA) with folic acid 1 mg per day. RESULTS: Thirty-nine patients eligible for treatment displayed a median age of 50.4 years. Eighteen patients completed treatment, 4 remain on treatment, and 17 were intolerant. Sustained HCV-RNA eradication occurred in 66.7% of patients who completed treatment. Side effects led to treatment withdrawal in 17 patients (43.6%) In an intention-to treat analysis, sustained HCV-RNA eradication occurred in 30.8% of patients. CONCLUSION: Side effects are an important limiting factor in the treatment of recurrent HCV with pegylated interferon and ribavirin. However, these results are encouraging as sustained HCV eradication occurred in at least 66.7% of patients who completed treatment. Prospective randomized trials are required to assess the effectiveness of this treatment and its impact on quality of life and histology.     

Pegylated interferon alfa-2a (40 kD) and ribavirin in haemodialysis patients with chronic hepatitis C.

BACKGROUND: Chronic hepatitis C virus (HCV) infection is associated with liver dysfunction and hepatocellular carcinoma. In patients with normal kidney function, treatment with pegylated interferon (PEG-IFN) and ribavirin (RBV) frequently leads to eradication of HCV. Treatment in dialysis patients has long been controversial and until recently, the use of RBV was considered to be contra-indicated. We used plasma trough levels of RBV to promote tolerance, safety and efficacy. PEG-IFN alfa-2a (40 kD) was chosen because it is cleared predominantly via hepatic metabolism. METHODS: Seven haemodialysis patients with chronic HCV infection were eligible and started with 135 microg PEG-IFN alfa-2a (40 kD) weekly and 200 mg RBV every other day. Dose adaptations were allowed following study guidelines. Genotypes 1 and 4 (five patients) were treated for 48 weeks and genotypes 2 and 3 (two patients) for 24 weeks. HCV-RNA was determined after 12, 24 and 48 weeks (and at 72 weeks for genotypes 1 and 4). RBV trough plasma levels were monitored regularly by HPLC-technique. RESULTS: All patients completed the treatment. In two patients, the PEG-IFN dose had to be reduced to 90 microg/week because of adverse events. To achieve the target range (1.5-2.5 microg/ml) of the plasma trough level, the mean RBV dose was increased to a dose between 133 and 200 mg each day in five patients. Despite an increase of the weekly erythropoietin (Epo) dose, two to a max of four red cell transfusions were given to four patients. A sustained viral response (SVR) was reached in five patients (3/5 with genotype 1/4 and 2/2 with genotype 2/3). CONCLUSION: In our series of seven patients, we were able to use RBV monitoring drug levels in combination with PEG-IFN alfa-2a (40 kD) and achieve high sustained response rates. However, Epo and transfusion requirements may increase. In two patients adverse events were observed, but manageable with dose reduction of PEG-IFN.     

Pegylated interferon alfa-2a and ribavirin for recurrent hepatitis C after liver transplantation

BACKGROUND: Recurrent hepatitis C virus (HCV) is often treated with interferon and ribavirin combination therapy but results have been disappointing. Given the promising results reported with pegylated interferon and ribavirin for hepatitis C, this combination is now preferred for the treatment of recurrent HCV. This article reports a transplantation program's experience with antiviral therapy treatment for liver transplant recipients with recurrent HCV. METHODS: Between October 2002 and June 2004, patients with recurrent HCV were screened to determine if they were eligible for treatment. Liver function tests, HCVRNA, and liver biopsies were done on all patients prior to treatment. HCVRNA was repeated at 3 months, end of treatment (EOT), and 6 months after EOT for patients HCVRNA-negative at EOT. Patients were prospectively followed up after starting weekly pegylated interferon alfa-2a 180 mcg/wk and ribavirin 1000-1200 mg/d (Roche, Nutley, NJ, United States) with folic acid 1 mg/d. RESULTS: Thirty-two patients were eligible for treatment with a median age of 49.2 years. Twenty-one patients have completed treatment, 6 remain on treatment, and 5 were intolerant. In an intention-to-treat analysis, sustained HCVRNA eradication occurred in at least 40.6% of patients. Side effects led to treatment withdrawal in 5 patients (15.6%). CONCLUSION: Pegylated interferon alfa-2a and ribavirin appear promising for the treatment of recurrent HCV. Side effects were an infrequent cause of treatment discontinuation, unlike previous combinations of interferon-based therapy. Randomized, prospective trials incorporating serial liver biopsies with appropriate quality of life analyses are required to manage this silent epidemic.     

Intravesical interferon alfa-2b administration in the treatment of superficial bladder tumors

This study was undertaken to assess the value of intravesical interferon alfa-2b treatment in preventing the recurrences of superficial transitional cell carcinoma of the bladder. A total of 30 patients aged from 33 to 78 entered the protocol. The intravesical instillations were performed once a week for 8 weeks. A solution of 10 x 10(6) IU interferon alfa-2b in 30 ml of normal saline was used. Follow-up ranged from 12 to 28 months. Of the 30 patients, 19 (63.33%) were tumor free at the end of follow-up. Of the remaining 11 patients, 7 presented with recurrent superficial tumors and 4 with invasive bladder tumors. No side effects were noted.