STUDIES OF THE NATURAL HISTORY AND TREATMENT OF CHRONIC TYPE C HEPATITIS

有充分证据的慢性丙型肝炎患者正在接受评估 来确定这种常见的 慢性肝病 这些患者的队列可用于 评估实验性疗法。 先前的研究表明，阿尔法 干扰素治疗具有短期有益效果， 50%的患者。 这种反应持续约 停用干扰素后20%。 一项随机、安慰剂对照 利巴韦林的试验表明，1年的这种核苷 类似物与显著改善血清 转氨酶活性和肝小叶坏死，尽管 血清HCV RNA水平不变。 持续利巴韦林治疗up 到2年证明了长期抑制治疗的实用性 在这种疾病中。一项逐步增加α干扰素剂量的试验 正在进行中 对前二十名患者的研究表明，一半 的无应答患者将对更高剂量的干扰素产生应答， 血清中HCV RNA的丢失。 有必要采取进一步的后续行动，以表明 这些对较高剂量的应答者在干扰素 停止了 已经设计了一项试验来治疗那些 对单独使用α干扰素没有反应， 干扰素和利巴韦林。

Patients with well-documented chronic hepatitis C are being evaluated to determine the long-term natural history of this common form of chronic liver disease. A cohort of such patients are available to evaluate experimental therapies. Previous studies have shown that alpha interferon therapy has a short-term beneficial effect in approximately 50 per cent of patients. This response is sustained in approximately 20 per cent after stopping interferon. A randomized, placebo-controlled trial of ribavirin showed that a 1 year course of this nucleoside analogue is associated with significant improvement in serum aminotransferase activities and in hepatic lobular necrosis despite unchanged serum levels of HCV RNA. Continous ribavirin therapy for up to 2 years demonstrated the practicality of long term supressive therapy in this disease. A trial of escalating doses with alpha interferon is underway. Studies in the first twenty patients reveals that one half of nonresponder patients will respond to higher doses of interferon with loss of HCV RNA from serum. Further follow-up is necessary to show that these responders to higher doses maintain the response when interferon is stopped. A trial has been designed for therapy of patients who do not respond to alpha interferon alone using the combination of interferon and ribavirin.