复合α干扰素治疗慢性丙型肝炎疗效与病毒负荷及合并TTV感染关系的随机对照研究
作者：郝连杰 沈汉馨 赵西平 齐俊英 汪由坤 郑昕
单位：430030 武汉同济医科大学同济医院临床免疫研究室
关键词：丙型肝炎，治疗；TTV；组合干扰素
肝脏000104摘 要：目的评价复合α干扰素(CIFN)治疗慢性丙型肝炎的效果，以及重叠TTV感染对治疗的影响。方法选择29例慢性丙型肝炎患者随机分成3组，A组(8例)给予CIFN15μg，B组(10例)给予CIFNμg，C组(11例，对照组)给予IFN-α2a，3MU，均为3次/周×24周，治疗结束后随访24周，于治疗结束时和随访结束时评价ALT及HCVRNA应答。采用套式聚合酶链反应方法对合并TTV感染情况进行回顾性研究。结果A、B两组治疗结束时及停药24周时的ALT复常率、血清HCVRNA阴转率均较对照组高，因样本量少均未达到统计学意义水平。综合比较CIFN和IPN-α2a的疗效，则前者随访结束时的持久应答率显著高于后者。2种剂量CIFN组间应答反应无明显区别。治疗前血清病毒含量与干扰素应答有关，CIFN对于高病毒负荷组患者的疗效优于IFN-α2a组。合并TTV感染者(8/22，36.4%)，重叠感染患者与非重叠感染者对干扰素应答反应无显著差别，8例TTV感染者CIFN治疗后6例血清TTVDNA阴转。结论CIFN治疗慢性丙型肝炎远期疗效及高病毒负荷患者的疗效较好；重叠TTV感染对慢性丙型肝炎干扰素疗效无明显影响。TTV似对CIFN较敏感。
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Randomized controlled study of consensus interferon therapy for chronic hepatitis C with or without superinfection of TTV and its relationship with serum HCV loading
HAO Lianjie,SHEN Hanxin,ZHAO Xiping,et al.
(Clinical Im-munology Research Unit,Department of Infectious Diseases,Tongji Hospital of Tongji Medical University,Wuhan 430030)
Abstract：Objective Evaluate the efficacy of consensus interferon (CIFN) therapy for chronic hepatitis C (CHC) and CHC superinfected with TT virus (TTV).Methods 29 subjects with CHC were randomized to receive CIFN 15μg (group A,n=8),CIFN 9μg (group B,n=10),and interferon-α 2a 3MU (group C,control,n=11) subcutaneously,3 times a week for 24 week followed by an other 24 weeks posttreatment observation,respectively.The end of treatment response (ETR) and end of follow-up response (sustained response,SR) were evaluated based on the serum ALT normalization and seronegative of HCV RNA.TTV infection in the patients was retrospectively analyzed with nested PCR detection of TTV DNA in serum.Re-suits The ALT and HCV RNA response rate in group A and B at the end of therapy as well as the end 24 weeks follow-up were greater than that in control gourp (group C),but without statistic significance.When compared the efficacy of CIFN treatment group with IFN-α 2a group,it was found that the SR rate in CIFN group was significantly higher than that in group C.There was no significant difference of the response in 9 and 15μg CIFN groups.The better response to CIFN therapy was observed in patients with higher serum HCV loading before treatment then the group of IFN-α 2a.TTV DNA was detected in 8 subjects from the 22 cases (36.4%).No obvious difference of the response to IFN was observed in the patients with and without TTV superinfection.Among 8 cases with TTV superinfection,6 had sustained serum negative of TTV DNA after therapy with CIFN.Conclusion CIFN is benificial for patients with CHC.TTV superinfection has no obvious influence on the response to IFN therapy in patients with CHC,and TTV seems to be sensitive to CIFN.
, http://www.100md.com
Keywords：Chronic hepatitis C;TT virus;Therapy;CIFN
参考文献：
[1]Gish RG.Standards of treatment in chronic hepatitis.Scm Liver Dis,1999,19:suppl 1,35-47.
[2]Keeffe EB,Hollinger FB,and the Consensus Interferon Study Group.Therapy of hepatitis C:Consensus Interferon Trials.Hepa-tology,1997,26:suppl 1,101-107.
[3]Yao GB,Fu XX,Tian GS,et al.A multicenter,randomized con-trolled trial of interferon alfacon-1 (CIFN) compared with interferon alfa-2a (IFN-α2a) in Chinese patients with chronic hepatitis C virus(HCV) infection.Digestion,1998,59:(suppl.3),306.
, http://www.100md.com
[4]Yamada G,Takatani M,Kishi F,et al.Efficacy of interferon alfa therapy in chronic hepatitis C patients depends primarily on hepatitis C virus RNA level.Hepatology,1995,22:1351-1354.
[5]Jensen DM,Krawitt EL,Keeffe EB,et al.Biochemical and viral response to consensus interferon (CIFN) therapy in chronic hepatitis C patients:effect of baseline viral concentration.Am J Gastroenterol,1999,94:3583-3588.
收稿日期：1999-12-20, http://www.100md.com
单位：430030 武汉同济医科大学同济医院临床免疫研究室
关键词：丙型肝炎，治疗；TTV；组合干扰素
肝脏000104摘 要：目的评价复合α干扰素(CIFN)治疗慢性丙型肝炎的效果，以及重叠TTV感染对治疗的影响。方法选择29例慢性丙型肝炎患者随机分成3组，A组(8例)给予CIFN15μg，B组(10例)给予CIFNμg，C组(11例，对照组)给予IFN-α2a，3MU，均为3次/周×24周，治疗结束后随访24周，于治疗结束时和随访结束时评价ALT及HCVRNA应答。采用套式聚合酶链反应方法对合并TTV感染情况进行回顾性研究。结果A、B两组治疗结束时及停药24周时的ALT复常率、血清HCVRNA阴转率均较对照组高，因样本量少均未达到统计学意义水平。综合比较CIFN和IPN-α2a的疗效，则前者随访结束时的持久应答率显著高于后者。2种剂量CIFN组间应答反应无明显区别。治疗前血清病毒含量与干扰素应答有关，CIFN对于高病毒负荷组患者的疗效优于IFN-α2a组。合并TTV感染者(8/22，36.4%)，重叠感染患者与非重叠感染者对干扰素应答反应无显著差别，8例TTV感染者CIFN治疗后6例血清TTVDNA阴转。结论CIFN治疗慢性丙型肝炎远期疗效及高病毒负荷患者的疗效较好；重叠TTV感染对慢性丙型肝炎干扰素疗效无明显影响。TTV似对CIFN较敏感。
, http://www.100md.com
Randomized controlled study of consensus interferon therapy for chronic hepatitis C with or without superinfection of TTV and its relationship with serum HCV loading
HAO Lianjie,SHEN Hanxin,ZHAO Xiping,et al.
(Clinical Im-munology Research Unit,Department of Infectious Diseases,Tongji Hospital of Tongji Medical University,Wuhan 430030)
Abstract：Objective Evaluate the efficacy of consensus interferon (CIFN) therapy for chronic hepatitis C (CHC) and CHC superinfected with TT virus (TTV).Methods 29 subjects with CHC were randomized to receive CIFN 15μg (group A,n=8),CIFN 9μg (group B,n=10),and interferon-α 2a 3MU (group C,control,n=11) subcutaneously,3 times a week for 24 week followed by an other 24 weeks posttreatment observation,respectively.The end of treatment response (ETR) and end of follow-up response (sustained response,SR) were evaluated based on the serum ALT normalization and seronegative of HCV RNA.TTV infection in the patients was retrospectively analyzed with nested PCR detection of TTV DNA in serum.Re-suits The ALT and HCV RNA response rate in group A and B at the end of therapy as well as the end 24 weeks follow-up were greater than that in control gourp (group C),but without statistic significance.When compared the efficacy of CIFN treatment group with IFN-α 2a group,it was found that the SR rate in CIFN group was significantly higher than that in group C.There was no significant difference of the response in 9 and 15μg CIFN groups.The better response to CIFN therapy was observed in patients with higher serum HCV loading before treatment then the group of IFN-α 2a.TTV DNA was detected in 8 subjects from the 22 cases (36.4%).No obvious difference of the response to IFN was observed in the patients with and without TTV superinfection.Among 8 cases with TTV superinfection,6 had sustained serum negative of TTV DNA after therapy with CIFN.Conclusion CIFN is benificial for patients with CHC.TTV superinfection has no obvious influence on the response to IFN therapy in patients with CHC,and TTV seems to be sensitive to CIFN.
, http://www.100md.com
Keywords：Chronic hepatitis C;TT virus;Therapy;CIFN
参考文献：
[1]Gish RG.Standards of treatment in chronic hepatitis.Scm Liver Dis,1999,19:suppl 1,35-47.
[2]Keeffe EB,Hollinger FB,and the Consensus Interferon Study Group.Therapy of hepatitis C:Consensus Interferon Trials.Hepa-tology,1997,26:suppl 1,101-107.
[3]Yao GB,Fu XX,Tian GS,et al.A multicenter,randomized con-trolled trial of interferon alfacon-1 (CIFN) compared with interferon alfa-2a (IFN-α2a) in Chinese patients with chronic hepatitis C virus(HCV) infection.Digestion,1998,59:(suppl.3),306.
, http://www.100md.com
[4]Yamada G,Takatani M,Kishi F,et al.Efficacy of interferon alfa therapy in chronic hepatitis C patients depends primarily on hepatitis C virus RNA level.Hepatology,1995,22:1351-1354.
[5]Jensen DM,Krawitt EL,Keeffe EB,et al.Biochemical and viral response to consensus interferon (CIFN) therapy in chronic hepatitis C patients:effect of baseline viral concentration.Am J Gastroenterol,1999,94:3583-3588.
收稿日期：1999-12-20, http://www.100md.com