| 特集名 | 肝疾患の予後 | |
|---|---|---|
| 題名 | B型慢性肝炎の予後－IFNによる修飾を含めて | |
| 発刊年月 | 1997年 10月 | |
| 著者 | 八橋 弘 | 国立長崎中央病院臨床研究部 |
| 著者 | 矢野 右人 | 国立長崎中央病院臨床研究部 |
| 【 要旨 】 | B型慢性肝炎患者の自然経過は，母子感染で感染が成立し，肝炎発症まで健康キャリアーとして推移する．青壮年期に入りGPT値の激しい変動を呈する慢性肝炎に移行し，その間に細胞性免疫によるHBV感染肝細胞の破壊を繰り返しながらHBV排除の方向へ向かう． 慢性肝炎の期間は5年以内の者が多く，この期間内に肝硬変進展例と臨床的治癒症例の2極に分化する．炎症が消退した状態でも肝硬変進展例は，癌化の可能性をもち続ける．IFN治療群と無治療群の長期予後の比較からは，両群間に差が認められず，現行のIFN治療がB型慢性肝炎患者の予後を改善しているとは言い難い． |
|
| Theme | Prognosis of Liver Diseases | |
|---|---|---|
| Title | Prognosis of Patients with Chronic Hepatitis B | |
| Author | Hiroshi Yatsuhashi | Institute for Clinical Research, Nagasaki Chuo National Hospital |
| Author | Michitami Yano | Institute for Clinical Research, Nagasaki Chuo National Hospital |
| [ Summary ] | Many HBV carriers are infected by the route of vertical transmission. Although they are asymptomatic, appear healthy, and their liver function tests are generally normal, some healthy HBV carriers progress to active chronic hepatitis as adults. After active chronic hepatitis with severe inflammation, HBV replication becomes silent and patients can be broadly divided into liver cirrhosis (LC) and clinical cure. Chronic hepatitis B patients with liver cirrhosis but without inflammation have a high potential for developing hepatocellular carcinoma (HCC). We compared the long term prognosis of patients with chronic hepatitis B between a no-treatment group and an IFN treatment group. The results showed that there was no difference in patient prognosis (incidence of LC, HCC and clinical cure) between the two groups. It is difficult to conclude that IFN treatment improves the prognosis of patients with hepatitis B. |
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