Interferon monotherapy for patients with chronic hepatitis C and normal serum aminotransferase levels at commencement of treatment
Interferon monotherapy for patients with chronic hepatitis C and normal serum aminotransferase levels at commencement of treatment
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干扰素单药治疗慢性丙型肝炎且治疗开始时血清转氨酶水平正常的患者
DOI：
10.1007/s00535-003-1388-0
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发表时间：
2004
影响因子：
6.3
通讯作者：
H. Kumada
中科院分区：
文献类型：
--
作者：
S. Mamori;F. Suzuki;T. Hosaka;N. Akuta;T. Someya;M. Kobayashi;A. Tsubota;Yoshiyuki Suzuki;S. Saitoh;Y. Arase;K. Ikeda;H. Kumada
研究背景约30%的慢性丙型肝炎患者血清丙氨酸氨基转移酶（ALT）水平正常。虽然干扰素（IFN）单药治疗被批准用于慢性丙型肝炎感染患者，但这种治疗对治疗开始时ALT水平正常的慢性丙型肝炎患者的有效性仍然知之甚少。（《古兰经》54：40;中位年龄，46岁），ALT水平正常（< 50 IU/l），抗丙型肝炎病毒（HCV）和血清HCV-RNA均阳性。在该组中，18名患者（男性/女性，9：9;中位年龄，50岁）在治疗前至少3个月内ALT水平持续正常。所有患者接受了他们的第一个疗程的IFN治疗在本study. ResultsForthree（45.7%）的94个人在6个月后停止治疗（完全反应，CR）失去了血清HCV-RNA。ALT正常组HCV-RNA水平> 1 Meq/ml的2a基因型患者CR率明显低于ALT升高组（23.8%vs55.6%，P= 0.0189）。2例ALT水平持续正常且HCV-RNA水平超过1 Meq/ml的患者为无应答者（NR），在IFN治疗后ALT突然升高。HCV-RNA水平小于1 Meq/ml的患者没有表现出基于ALT levels.ConclusionsOur数据的差异反应表明，IFN治疗是有效的ALT水平正常，小于1 Meq/ml HCV-RNA的患者。因此，这些患者应考虑治疗性IFN治疗。
BackgroundApproximately 30% of patients with chronic hepatitis C have normal serum alanine amino transferase (ALT) levels. While interferon (IFN) monotherapy is approved for patients with chronic hepatitis C infection, the effectiveness of such therapy for chronic hepatitis C patients with normal ALT levels at commencement of treatment remains poorly understood.MethodsNinety-four individuals (M/F, 54 : 40; median age, 46 years) with normal ALT levels (< 50 IU/l) at the commencement of treatment who were positive for both anti-hepatitis C virus (HCV) and serum HCV-RNA were studied. Among this group, 18 individuals (M/F, 9 : 9; median age, 50 years) had had persistently normal ALT levels for at least 3 months prior to treatment. All patients received their first course of IFN therapy in this study.ResultsForty-three (45.7%) of 94 individuals had lost serum HCV-RNA at 6 months after cessation of therapy (complete response; CR). The proportion of patients with genotype 2a and HCV-RNA level over 1 Meq/ml who showed CR was significantly lower in those with normal ALT levels than in those with elevated ALT levels (23.8% vs 55.6%;P= 0.0189). Two patients who had persistently normal ALT levels and HCV-RNA level over 1 Meq/ml were nonresponders (NR) and had ALT flare-ups after IFN therapy. Patients with HCV-RNA levels of less than 1 Meq/ml did not show differential responses based on ALT levels.ConclusionsOur data suggest that IFN therapy is effective for patients with normal ALT levels and less than 1 Meq/ml HCV-RNA. Thus, such patients should be considered for curative IFN therapy.