摘要
检索1988年至1996年MEDLINE关于α-IFN治疗HBV preC/C基因突变株感染的资料,用Meta-analysis方法,评价α-IFN治疗血清抗-HBe和HBV DNA同时阳性患者的疗效。结果表明,α-IFN治疗HBV preC/C基因突变株感染是有效的,疗效与α-IFN治疗HBV野生株相似;α-IFN本身不引起HBV preC/C基因变异,但对混合感染者,α-IFN在消灭野生株的同时,有可能促使突变株成为体内优势毒株。
A meta-analysis was performed to evaluate the effect of interferon alfa (IFN-a)on patients infected with precore and/or core mutants of hepatitis B virus (HBV).This was done by reviewing 24 papers present in MEDLINE data bank, of which 8 controlled trials had a posttreatment follow-up period of at least 12 months.The Mantel-Haensel method was applied to extrapolate these data.Of the 90 patients treated with IFN-a in four randomized controlled trials, 32(35.6%)were complete responders, which was significantly greater in contrast to 7 (7.8%) spontaneous remission out of 90 patients in control group.Studies in five trials also showed that 32(40.5%) of 79 patients infected with wild-type HBV and 28(35.9%) of 78 patients with preC/C mutanted virus completely responded to IFN-a treatment.The wild-type HBV were sequenced before and after IFN-a treatment in two trials, and 14 (35.0%)of 40 patients treated with IFN-a vs 36(81.8% )of 44 patients in control group had preC/C gene mutation after observation period of 12 months, indicating that IFN-a does not induce but could inhibit the mutation of HBV preC/C gene.The protocol of 5 megaunits of IFN-a administered intramuscularly three times a week for 6 months was better than other protocol? for treatment of chronic hepatitis B with preC/C gene mutation.Further studies should be done to evaluate the efficacy of IFN-a in patients with hepatitis B preC/C gene mutant infection.
出处
《实用肝脏病杂志》
CAS
1998年第2期88-90,共3页
Journal of Practical Hepatology
