重组干扰素对慢性丙型肝炎抗病毒疗效5年随访观察

目的观察重组干扰素α－２ａ，α－２ｂ抗丙型肝炎病毒（ＨＣＶ）的近、远期疗效。方法重组干扰素α－２ａ治疗组７０例，重组干扰素α－２ｂ４６例对照组２８例，治疗后随访５年。结果治疗结束时，ＨＣＶＲＮＡ阴转率和血清ＡＬＴ复常率α－２ａ组分别为６７１４％和７０００％，α－２ｂ组分别为６９５６％和７１７３％，随访５年后，α－２ａ组ＨＣＶＲＮＡ阴转率和血清ＡＬＴ复常率分别为３５７１％和４７１４％，α－２ｂ组分别为３９１３％和５２１７％，均显著高于对照组（Ｐ＜００１和Ｐ＜００５）。基因分型以ＨＣＶⅠ组感染为主（７５８６％），干扰素对ＨＣＶⅡ组感染的疗效优于ＨＣＶⅠ组。结论重组干扰素α－２ａ与α－２ｂ均为有效的抗丙型肝炎病毒药物，慢性丙型肝炎患者干扰素治疗的早期疗效较好。ＨＣＶ基因型有预测干扰素疗效的意义

A 5-year follow-up study of antiviral effect of interferon in patients with chronic hepatitis C

In order to discuss the anti-viral effects of IFN alpha-2a and IFN alpha-2b on chronic hepatitis C in a short and long period of time after treatment, 70 cases of chronic hepatitis C treated with IFN alpha-2a, 46 cases with IFN alpha-2b and 28 cases as controls had been investigated in this study. The follow-up time began from half to 5 years. The serum negative conversion rate of HCV RNA and the normalization of serum alanine transaminase(ALT) were detected at the end of treatment and up to 5 years after therapy. The negative seroconversion rate of HCV RNA and the serum ALT normalization were 67.14% and 70.00% respectively in IFN alpha-2a group and 69.56%, 71.71% respectively in IFN alpha-2b group at the end of the treatment. After 5-year follow-up, the above two Indexes were 35.71%, 47.14% respectively in IFN alpha-2a group, and 39.13%, 52.17% respectively in IFN alpha-2b group. The effectiveness in treated patients was higher than that of controls (P < 0.01 and P < 0.05). Recombinant IFN alpha-2a and IFN alpha-2b are effective medicines for HCV infection. And interferon therapy had a high short-term complete response but a low long-term complete response in the treatment of chronic hepatitis C. HCV genotype seems to be an important factor in determining the response rate of IFN treatment in patients with chronic hepatitis C.