长疗程低剂量α-干扰素口含治疗丙型肝炎合并庚型肝炎的临床流行病学研究

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目的 了解庚型肝炎病毒 (HGV)对α 干扰素治疗的反应以及治疗前后HGV与丙型肝炎病毒 (HCV)合并感染者病毒血症的动态变化。方法 对研究对象用药前、用药 3和 6个月时肝功能、血清HGVRNA及HCVRNA等的动态变化进行观察。以阳性率和阴转率为主要评价指标并经统计学分析。结果 经α 干扰素治疗 3和 6个月时 ,治疗组的ALT水平呈下降趋势 ,特别是治疗 6个月时 ,ALT平均水平从治疗前的119 6IU/L降至 5 6 2IU/L ,显著低于 6个月时安慰剂组ALT平均水平 (12 6IU/L)。治疗组血清HGVRNA阴转率在治疗 3和 6个月时分别为 6 4 7%和 6 4 7% ,安慰剂组分别为 6 0 0 %和 6 6 7%。两组无显著性差异。用α 干扰素治疗的 17例病人中 ,于治疗 6个月时 ,3例血清HGVRNA阴转而HCVRNA仍为阳性的病人 ,其ALT水平仍维持在较高水平 ,分别为15 4、16 8和 84IU/L。 3例血清HGVRNA阳性而HCVRNA阴转者 ,其ALT水平均转为正常 ,分别为 2 5、2 0和 2 0IU/L。 3例血清HGV和HCVRNA均阳性者 ,其ALT水平仍为异常。8例HGV和HCVRNA均阴转者 ,除 1例ALT由 70IU/L降至 35IU/L外 ,其余 7例病人的ALT均降低至正常水平。结论 HGV感染具有较高的自限性 ,长疗程低剂量口含α 干扰素对HGVRNA阴转无明显作用。 Objective To understand the response of hepatitis G virus (HGV) to treatment with interferon alfa and the changes of viremia in patients with and without HGV and hepatitis C virus (HCV) before and after treatment. Methods The changes of liver function, serum HGVRNA and HCV RNA in the study subjects before and 3 and 6 months after treatment were observed. The positive rate and negative rate as the main evaluation index and statistical analysis. Results The levels of ALT in treatment group showed a decreasing trend at 3 and 6 months after treatment with interferon alpha, especially at 6 months, the average level of ALT dropped from 119 6 IU / L to 562 IU / L before treatment The mean ALT in placebo group was lower than 6 months (12 6 IU / L). In the treatment group, the HGVRNA negative conversion rates were 64.7% and 64.7% at 3 and 6 months of treatment, respectively, and were 60.0% and 66.7% in the placebo group, respectively. No significant difference between the two groups. Of the 17 patients treated with interferon alpha, ALT levels remained high at 3 months after 6 months of treatment in 3 patients whose serum HGVRNA was negative and HCVRNA was still positive, at 15 4,168 and 84IU / L. Three patients with positive serum HGVRNA and negative HCVRNA turned their normal ALT levels to 25, 20 and 20 IU / L, respectively. Three patients with positive serum HGV and HCVRNA were still abnormal ALT levels. 8 cases of HGV and HCVRNA were negative conversion, except for 1 case of ALT decreased from 70IU / L to 35IU / L, the remaining 7 patients ALT were reduced to normal levels. Conclusions HGV infection has high self-limiting. The long-course low-dose oral interferon-alpha has no obvious effect on HGVRNA negative conversion.
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