干扰素-α抗病毒治疗B、C基因型慢性乙型肝炎患者的疗效对比分析

Comparison of interferon-α antiviral effectiveness between genotype B and C CHB patients

目的比较使用干扰素-α抗病毒治疗B、C基因型慢性乙型肝炎患者的疗效差异，探讨使用干扰素-α治疗慢性乙型肝炎时维持明显疗效的最长疗程。方法89例慢性乙型肝炎患者，B基因型38例，C基因型51例，测定两种基因型患者中使用干扰素-α 6、12、18、24个月（分别为6、12、18、24个月组）疗程的血清HBV—DNA、丙氨酸氨基转移酶（ALT）水平及HBeAg血清转换状况，比较两种基因型患者中使用干扰素-α不同疗程组以上指标的变化及两种基因型患者之间以上指标的总体差异。结果（1）B、C基因型乙型肝炎患者18个月疗程组的血HBV—DNA、ALT水平均明显低于6、12个月组，HBeAg血清转换率均明显高于6、12个月组。（2）疗程24个月组与18个月组相比，两种基因型患者血清HBV—DNA水平比较，差异均无统计学意义；B基因型患者24个月组血ALT水平仍明显低于18个月组，HBeAg血清转换率仍明显高于18个月组；C基因型患者血ALT水平及HBeAg血清转换率在24个月组与18个月组之间差异均无统计学意义。（3）B基因型患者总体HBV—DNA水平、ALT水平均明显低于C基因型患者，总体HBeAg血清转换率明显高于C基因型患者。结论（1）用干扰素-α抗病毒治疗B、C基因型HBV感染的慢性乙型肝炎患者，18个月疗程时干扰素-α的抑制病毒复制、抗肝脏炎症及免疫调节效应均较6、12个月疗程时疗效继续明显增加。（2）干扰素-α对B基因型患者的抗病毒疗效总体优于C基因型患者。

Objective To compare the difference ofinfefferon（IFN）-a antiviral effectiveness between CHB patients infected with genotype B HBV and genotype C HBV, and investigate the longest course of treatment of IFN-α maintaining distinct antiviral effectiveness. Methods Eighty-nine CHB patients were divided into two groups （B genotype group 38 cases, C genotype group 51 cases） according to genotype of HBV which infected CHB patients,detected serum HBV-DNA levels, ALT levels and determined HBeAg seroconversion status when they were treated with IFN-α for 6, 12, 18 and 24 months respectively,compared the difference of these indexes in two groups and treated with IFN-α for different course of treatment and the difference of total levels of serum ALT, HBV-DNA and HBeAg seroconversion rates in two groups. Results Serum HBV-DNA and ALT levels were all lower and HBeAg seroconversion rates were higher in IFN-α 18 months than those in IFN-α 6 months and IFN-α 12 months in two groups. There were no significant difference in serum HBV-DNA levels between IFN-α 24 months and IFN-α 18 months in two groups. Serum ALT levels were still lower and HBeAg seroconversion rates were evidently higher in IFN-α 24 months than those in IFN-α 18 months in B genotype group but there were no significant difference in serum ALT levels and HBeAg seroconversion rates between IFN-α 24 months and IFN-α 18 months in C genotype group. Total serum HBV-DNA and ALT levels were all lower and total HBeAg seroconversion rates were higher in B genotype group than those in C genotype group. Conclusions Antivi- ral effectiveness of IFN-α in both genotype B CHB patients and genotype C CHB patients markedly increase continually when it is used for 18 months compared with 12 months. The general antiviral effectiveness of IFN-α are better in genotype B CHB patients than those in genotype C CHB patients.