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

一组慢性B型肝炎患者正在接受 评估和跟踪，以确定长期的自然历史 这种常见的慢性肝病。 选择的患者 尚未进入抗病毒和/或 免疫调节剂。 目前正在努力 提高对单独干扰素的应答率。 的初步研究 α和γ干扰素的联合治疗已经完成。 虽然α干扰素诱导了病毒的剂量依赖性抑制， DNA聚合酶活性，γ干扰素几乎没有或没有影响 这种酶。 此外，γ干扰素与 比α干扰素更严重的副作用 当用于 联合使用时，没有累加或协同抗病毒作用。 很明显 两项新的研究使用α干扰素作为治疗 慢性B型肝炎正在进行中。 第一个是随机的， 对照试验重新评估α干扰素的作用 单独使用（每周三次，剂量为1000万单位）， 在没有潜在可能的因素的患者中没有治疗 干扰治疗反应。 到目前为止，已有5名患者 已输入，尚未获得结果。 第二项研究是 专为单用干扰素无反应的患者设计 在以前的研究中。 在这些情况下，预处理的效果 在给药前给予泼尼松4周疗程， 干扰素正在评估中。 希望广大 快速停用皮质类固醇的免疫刺激作用， 通过诱发肝炎活动的恶化， 优化α干扰素的抗病毒效果。 六名患者 到目前为止，已进入本研究，尚未完成 用药

A cohort of patients with chronic type B hepatitis is being evaluated and followed to determine the long-term natural history of this common form of chronic liver disease. Selected patients nave been entered into therapeutic trials of antiviral and/or immunomodulatory agents. Efforts are now being directed towards improving the response rate to interferon alone. A pilot study of alpha and gamma interferon in combination has been completed. While alpha interferon induced a dose-dependent inhibition of viral DNA polymerase activity, gamma interferon had little or no effect on this enzyme. In addition, gamma interferon was associated with more severe side effects than alpha interferon. When used in combination, no additive or synergistic antiviral effects were apparent. Two new studies using alpha interferon as therapy for chronic type B hepatitis are underway. The first is a randomized, controlled trial to reevaluate the effects of alpha interferon alone (at a dose of 10 million units three times weekly) compared to no therapy in patients without factors that may potentially interfere with the therapeutic response. So far five patients have been entered and no results are yet available. A second study is designed for patients who have not responded to interferon alone in previous studies. In these cases, the effect of pretreatment with a 4 week course of prednisone before administration of interferon is being evaluated. It is hoped that the immunostimulatory effects of rapid withdrawal of corticosteroids, by inducing an exacerbation of hepatitis activity will tend to optimize the antiviral effects of alpha interferon. Six patients have been entered into this study so far, none has yet completed the treatment.