特集名 | 肝炎のインターフェロン治療 -- 総まとめ | |
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題名 | C型肝炎のインターフェロン治療 (5) インターフェロン治療の再投与でどのくらい効果が期待できるのか | |
発刊年月 | 2000年 10月 | |
著者 | 荒瀬 康司 | 虎の門病院消化器科 |
著者 | 熊田 博光 | 虎の門病院消化器科 |
【 要旨 】 | C型慢性肝炎に対するインターフェロン(IFN)再投与での治療効果につき検討した.IFN投与期間6カ月までの再投与を導入された例は305例であったが,うち27例(8.9%)はIFNの副作用のため投与の中止ないし減量を余儀なくされた.IFN再投与を遂行しえた278例について著効(virological response)達成の因子について検討した.著効は, (1).初回IFN投与中のHCV-RNA(-)達成例 (2).IFN再投与開始時のHCV-RNA量が1Meq/ml未満と低い例 (3).HCV-genotypeが2a,2bの例 (4).再投与時のIFN総量が初回投与時の総量の1.3倍以上投与例 の条件が満足された場合に高率であった.また,初回IFN投与終了後ALTの再上昇がみられ,ALTの回復期にはしばしばHCV-RNAの低下がみられるので,この時期にIFNの再投与を開始すれば著効率が高まることが期待される. |
Theme | Interferon Therapy for Viral Hepatitis : an Update Handbook | |
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Title | Interferon Retreatment of Nonresponders with HCV-RNA-positive Chronic Hepatitis C | |
Author | Yasuji Arase | Department of Gastroenterology, Toranomon Hospital |
Author | Hiromitsu Kumada | Department of Gastroenterology, Toranomon Hospital |
[ Summary ] | Interferon has been shown to be an effective treatment for some patients with chronic hepatitis-C. In this study, the value of retreatment of nonresponders to interferon was investigated. Two hundred seventy-eight patients who were nonresponders to the first in terferon therapy were retreated with interferon. In respect to HCV-RNA after the first interferon therapy, virological response(VR) occurred in 27.4%(51/186) of patients who were negative for HCV-RNA after the first interferon therapy, whereas only 3.3% (3/92) of the patients who were positive for HCV-RNA at that time had VR. Secondly, concerning serum levels of HCV-RNA before interferon retreatment, VR occurred in 44% (40/91) of patients who had serum HCV RNA levels of less than 1Meq/ml, whereas only 7.5% (14/187) of the patients who had HCV-RNA levels of 1Meq/ml or more than 1Meq/ml. In conclusion, we found that interferon retreatment might be a worth while strategy for patients with HCV-RNA levels of less than 1Meq/ml or for those with transient negative levels of HCV-RNA during or after initial interferon therapy. |