干扰素治疗后病毒性肝炎病人干扰素中和抗体的检测及意义

DETECTION OF ANTI INTERFERON NEUTRALIZING ANTIBODY FROM VIRAL HEPATITIS PATIENTS RECEIVING INTERFERON TREATMENT

使用４种α－干扰素的９８例病毒性肝炎病人，在治疗前、治疗期间及治疗后定期检测抗干扰素中和抗体，结果发现阳性率为３４．７％，该抗体的产生与病人的性别、年龄、治疗前ＡＬＴ水平、肝炎病毒感染类型、以及肝炎的临床类型均无显著相关；低剂量干扰素较易产生中和抗体；使用不同干扰素制剂产生中和抗体存在差异，其中以ｒＩＦＮα２ａ最高，ＩＦＮαＮ１最低；但中和抗体的出现对干扰素的抗病毒疗效影响不大，由于病例数较少，干扰素治疗期间出现的肝炎再活动现象与抗干扰素中和抗体产生的关系，未能下结论。

The authors tested for the presence of anti IFN neutralizing antibody by means of biological neutralization assay technique in 98 cases of viral hepatitis before, during and after treatment with different subtypes of IFN alpha. Thirty four patients (34 7%) developed such kind of antibody 1～6 months after the start of treatment. No significant differences were observed on the distribution fo sex, age, pretreatment ALT level, type of hepatitis viruses and clinical types of hepatitis between the group of cases who developed neutralizing antibody and the group who did not. But the average dose of IFN in the former group was significantly lower than the latter group (P<0.01). In cases treated with different preparations of IFN alpha, the seroconversion rates of neutralizing antibody were 45.5%, 11.1%,25%,and 6.3% for rIFN alpha 2a, rIFN alpha 2b, rIFN alpha 1a and IFN alpha N1 respectively (P<0.005). On the other hand, in the evaluation of clinical response after IFN alpha treatment, no significant differences were found between the group of cases who developed neutralizing antibody and the group who did not, in respect to complete response, partial response, and no response. These results suggested that the presence of neutralizing antibody in patients treated with IFN alpha might not interfere with the antiviral response to IFN.