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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CIFN9μg,C组(11例,对照组)给予IFNα2a,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IFNα2a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IFNα2a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。
Objective To evaluate the efficacy of combination interferon-alpha (CIFN) in the treatment of chronic hepatitis C and the impact of overlapping TTV infection on treatment. Methods Twenty-nine patients with chronic hepatitis C were randomly divided into three groups: group A (8 cases) with CIFN15μg; group B (10 cases) with CIFN9μg; group C (11 cases, control group) with IFNα2a and 3MU, / Week × 24 weeks, 24 weeks after the end of treatment, ALT and HCVRNA responses were evaluated at the end of treatment and at the end of follow-up. A retrospective study was conducted on the prevalence of combined TTV infection using a nested polymerase chain reaction method. Results The ALT normalization rate and serum HCVRNA negative conversion rate were higher in the A and B groups than those in the control group at the end of treatment and at the 24th week of treatment. A comprehensive comparison of CIFN and IFNα2a efficacy, the former at the end of the long-term response rate was significantly higher than the latter. There was no significant difference in response between the two doses of CIFN. Pre-treatment serum viral levels and interferon response, CIFN in patients with high viral load group is better than IFNα2a group. There were no significant differences in response to interferon between patients with and without overlap in patients with TTV infection (8/22, 36.4%), and 6 patients with TTV infection had negative TTTVNA in 6 patients after CIFN treatment. Conclusion CIFN treatment of chronic hepatitis C long-term efficacy and high viral load in patients with better curative effect; overlapping TTV infection on chronic hepatitis C interferon no significant effect. TTV seems more sensitive to CIFN.