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临床研究已证实α-干扰素(IFN-α)可致约1/3慢性乙型肝炎患者的乙型肝炎病毒(HBV)复制完全抑制以及HBe血清转化、HBeAg消失及抗-HBe出现。也有人报道IFN治疗肝硬变有效。于HBe血清转化前通常可见与淋巴细胞引起肝细胞溶解加重有关的血清转氨酶中度升高。本文报道1例用IFN引起慢性乙型肝炎致死性恶化。患者男性,62岁,因慢性乙型肝炎而用IFN-α治疗,患者无任何肝硬变并发症。治疗前血清丙氨酸转氨酶(ALT)持续性升高,凝血酶原时间15.5S,胆红质8μmol/L。血清HBsAg、HBeAg及HBV DNA均阳性,抗-HIV、抗-HCV及抗δ因子均阴性。肝活检为慢性乙型肝炎伴肝硬变,免疫化学检测证实约20％的肝细胞核中有HBcAg。用IFN
Clinical studies have demonstrated that interferon-alpha (IFN-α) can cause complete suppression of hepatitis B virus (HBV) replication in approximately one third of patients with chronic hepatitis B as well as HBe seroconversion, HBeAg loss and anti-HBe. It has also been reported that IFN is effective in treating cirrhosis. A moderate elevation of serum aminotransferases associated with lymphocyte-induced hepatolysis is generally seen prior to HBe seroconversion. This article reports a case of IFN-induced lethal deterioration of chronic hepatitis B. The patient, male, 62 years old, was treated with IFN-α for chronic hepatitis B and had no complications of cirrhosis. Pretreatment serum alanine aminotransferase (ALT) continued to rise, prothrombin time 15.5S, bilirubin 8μmol / L. Serum HBsAg, HBeAg and HBV DNA were positive, anti-HIV, anti-HCV and anti-δ-factor were negative. Liver biopsy for chronic hepatitis B with cirrhosis, immunochemical tests confirmed that about 20% of liver cell nuclei have HBcAg. With IFN