重组α干扰素治疗慢性病毒性肝炎干扰素中和抗体的产生

PRODUCTION OF INTERFERON ALPHA NEUTRALIZING ANTIBODIES IN PATIENTS WITH CHRONIC VIRAL HEPATITIS TREATED WITH RECOMBINANT INTERFERON ALPHA

为探讨重组α干扰素 (IFNα)治疗慢性病毒性肝炎时 ,IFNα中和抗体 (NA)的产生和影响。采用抗病毒生物中和测定法检测 32 1例 IFNα治疗的慢性病毒性肝炎患者中的 NA。结果 :32 1例患者治疗前均未检出NA,治疗后检出 NA共 39例 (1 2 .1 % ) ,其中于治疗后 3、4、5和 6个月及 6个月后检出的分别为 2、6、1 1和 1 2例及 8例。NA阳性组病毒反跳率及病毒无应答率均显著高于 NA阴性组 (P<0 .0 1 )。 35例 NA阳性的患者在 NA阳性后换用天然淋巴母细胞干扰素 (IFN- αNl) ,其中病毒反跳组 1 5例中有 1 3例出现病毒阴转 ,病毒无应答组 1 8例中有 8例病毒阴转。结论 :IFNα治疗慢性病毒性肝炎 NA阳性率不高。 NA可以影响 IFNα的疗效。 NA阳性后换用

To study the production and clinical significance of interferon alpha(IFNα) neutralizing antibodies (NA) in patients with chronic viral hepatitis treated with recombinant interferon alpha. METHODS:NA was assayed by antiviral neutralizing bioassay in 321 chronic viral hepatitis patients treated with recombinant interferon alpha. The results showed that NA were detected in 39 of 312 (12.1%) patients after recelving the therapy, with 2 patients in 3 months 6 patients, in 4 months, 11 patients in 5 months, 12 patients in 6 month; and 8 patients in more than 6 months. The virus recrudescence rate and viral non response rate were higher in NA positive group than in NA negative group ( P <0.01). In 35 NA positive patients IFNα was replaced by natural lymphoblastoid interferon (IFNα N1) after NA development. 13 of 15 viral relapse patients and 8 of 18 patients without viral response became viral clearance. The results indicated that the NA incidence was low in patients with chronic viral hepatitis treated with recombinant interferon alpha. NA reduced the effectiveness of IFN. IFNαN1 should be chosen to replace rIFNα in order to improve the effectiveness of rIFNα after NA development.