| 摘 要： | AIM:Smoking may affect adversely the response rate tointerferon-α.Our objective was to verify this issue amongchronic hepatitis C patients.METHODS:Over the year 1998,138 chronic hepatitis Cmale Egyptian patients presenting to Cairo Liver Center,were divided on the basis of smoking habit into:group Iwhich comprised 38 smoker patients(>30 cigarettes/d)and group Ⅱ which included 84 non-smoker patients.Irregular and mild smokers(16 patients)were excluded.Non eligible patients for interferon-α therapy were excludedfrom the study and comprised 3/38(normal ALT)in groupI and 22/84 in group Ⅱ(normal ALT,advanced cirrhosisand thrombocytopenia).Group I was randomly allocatedinto 2 sub-groups:group Ia comprised 18 patients whowere subjected to therapeutic phlebotomy while sub-groupIb consisted of 17 patients who had no phlebotomy.Insub-group la,3 patients with normal ALT after repeatedphlebotomies were excluded from the study.Interferon-α2b 3 MU/TIW was given for 6 mo to 15 patients in groupIa,17 patients in group Ib and 62 patients in group Ⅱ.Biochemical,virological end-of-treatment and sustainedresponses were evaluated.RESULTS:At the end of interferon-α treatment,ALT wasnormalized in 3/15 patients(20%)in group Ia and 2/17patients(11.8%)in group Ib compared to17/62 patients(27.4%)in group Ⅱ(P=0.1).Whereas 2/15 patients(13.3%)in group Ia.and 2/17 patients(11.8%)in group Ib lostviraemia compared to 13/62 patients(26%)in group Ⅱ(P=0.3).Six months later,ALT was persistently normalin 2/15 patients(13.3%)in group 1a and 1/17 patients(5.9%)in group Ib compared to 9/62 patients(14.5%)ingroup Ⅱ(P=0.47).Viraemia was eliminated in 1/15 patients(6.7%)in group Ia and 1/17 patients(5.9%)in group Ibcompared to 7/62 patients(11.3%) in group Ⅱ,but theresults did not mount to statistical significance(P=0.4).CONCLUSION:Smokers suffering from chronic hepatitisC tend to have a lower response rate to interferon-α compared to non-smokers.Therapeutic phlebotomy improves theresponse rate to interferon-α therapy among this group.
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