干扰素的治病原理.

StephenW

干扰素已使用多年与慢性乙型肝炎的治疗。
干扰素对通过两种机制使出HBV感染者的抗病毒效果[19]。
首先，IFN有直接的抗病毒作用，抑制病毒的合成DNA和抗病毒酶(enzyme)的激活。其次，IFN 夸大细胞的免疫反应, 增加对HBV感染的肝细胞的免疫反应,增加 Class I类组织相容性抗原( class I histocompatibility antigen)的表达,刺激辅助性T淋巴细胞(T helper cells)和自然杀伤细胞(natural killer cells)的活动。
因此，干扰素诱导早期乙肝病毒复制的减少（反映乙肝病毒(HBV-DNA)血清中的减少）和血清中晚期（约2个月后）增加谷丙转氨酶（ALT）水平。
有许多对照(controlled)研究干扰素用于慢性B型肝炎病人的报道。在这些研究中，使用不同的方案，用干扰素组和安慰剂组:
病毒学应答率分别为37％与17％，
HBeAg消失的平均率为33％和12％，
乙肝表面抗原（HBsAg）消失的平均率8％与2％.

剂量为500万unit - 1000万unit，每周三次为4至6个月，结合了良好的与令人满意的宽容疗效[4]。


http://www.med.upenn.edu/gastro/documents/ClinLiverDisHBVandinterferon.pdf
IFN has been used in the treatment of chronic hepatitis B for many years.
IFN exerts an antiviral effect on HBV infection through two mechanisms
[19]. First, IFN has a direct antiviral effect, inhibiting synthesis of viral
DNA and activating antiviral enzymes. Second, IFN exaggerates the cellular
immune response against hepatocytes infected with HBV by increasing the
expression of class I histocompatibility antigens and by stimulating the activity
of helper T lymphocytes and natural killer lymphocytes. Thus, IFN
induces an early reduction of HBV replication (reflected by a reduction of
HBV DNA in serum) and a late (about 2 months later) increase in serum
alanine aminotransferase (ALT) levels. Many controlled studies of IFN in
patients who have chronic hepatitis B have been reported. In these studies,
using various regimens, mean virologic response rate was 37% versus 17%,
the mean rate of HBeAg loss was 33% versus 12%, and the rate of hepatitis
B surface antigen (HbsAg) loss was 8% versus 2% in the interferon-treated
groups versus the placebo groups (Fig. 1) [5]. A dosage of 5 million units
(MU) to 10 MU, three times per week for 4 to 6 months, combines good
efficacy with satisfactory tolerance [4].

CATBALOU

老半

StephenW

[谷歌翻译不是100％准确，仅供参考]

一个用于治疗乙型肝炎的药物是聚乙二醇干扰素（商品名派罗欣）。在每周注射干扰素，管理，加强你的免疫系统以帮助它对抗B型肝炎病毒（HBV）。
医生可能会开干扰素48周，如果你的谷丙转氨酶（ALT）水平高于正常。这意味着你的免疫系统正在积极战斗在您的肝脏的乙肝病毒感染。当你的免疫系统攻击的HBV感染的肝细胞，受损细胞释放ALT。
干扰素效果最好时，你的ALT水平升高时，你的病毒载量低。
所以，当你的ALT水平升高，医生可能会开干扰素，帮助过乙肝病毒的免疫系统抵抗。
HBeAg阳性患者：
在临床试验中，约27至32％的人的“e”抗原（HBeAg阳性）能够得到摆脱HBeAg, 发展“E”的抗体，干扰素治疗后，39％，取得了正常的ALT水平。
HBeAg阴性的患者：
约63％的患者达到检测不到病毒载量（HBV - DNA）和38％，取得了正常的ALT水平。
记住.............
•如果您有e抗原，干扰素能降低你的病毒载量25％的时间内检测不到的水平，并产生正常的ALT水平在39％的患者。
•如果您有HBeAg阴性乙肝，干扰素能产生无法检测的病毒载量63％的时间和正常的ALT水平38％的时间。
•研究表明，患者HBV基因型A和B更好地应对比其他基因型干扰素。
•干扰素是一种昂贵的药物，但它只有48周。
•干扰素工作有效, 免疫系统必须战斗B型肝炎感染（表示高ALT水平表示)。
•在一些人，干扰素会导致疲劳和中度至严重的抑郁症。

One drug used to treat hepatitis B is pegylated interferon (brand name Pegasys). Interferon, administered in a weekly injection,strengthens your immune system
to help it fight the hepatitis B virus (HBV).
Doctors may prescribe interferon for 48 weeks if your alanine aminotransferase (or ALT) level is above normal. This means your immune system is actively fighting
the HBV infection in your liver. When your immune system attacks your HBV-infected liver cells, the damaged cells release ALT.
Interferon works best when your ALT levels are elevated, and your viral load is low.
So, when your ALT level is elevated, doctors may prescribe interferon to help the immune system fight off HBV.
HBeAg-positive patients:
In clinical trials, about 27 to 32% of people who have the “e” antigen (HBeAg positive) were able to get rid of the HBeAg and develop the “e” antibody after interferon treatment, and 39% achieved normal ALT levels.
HBeAg-negative patients:
About 63% of these patients achieved undetectable viral load (HBV DNA) and 38% achieved normal ALT levels.

Remember.............
• If you have HBeAg, interferon can lower your viral load to
undetectable levels 25% of the time, and produce normal ALT
levels in 39% of patients.
• If you have HBeAg-negative hepatitis B, interferon can produce
undetectable viral load 63% of the time and normal ALT levels
38% of the time.
• Studies suggest that patients with HBV genotypes A and B
respond better to interferon than other genotypes.
• Interferon is an expensive drug, but it only has to be taken for 48
weeks.
• The immune system must be fighting the hepatitis B infection
(indicated by high ALT levels) for interferon to work.
• In some people, interferon causes fatigue and moderate to
severe depression.

VERSION 3.2 • March 2010
Alan Franciscus
http://www.hbvadvocate.org/hepatitis/easyBfacts/Pegylated%20Interferon_10.pdf

lin12345

46565215

好呀

看到未来

了解.很有用的

StephenW

IFN有直接的抗病毒作用，抑制病毒的合成DNA和抗病毒酶(enzyme)的激活.
http://www.hopkins-gi.org/GDL_Disease.aspx?CurrentUDV=31&GDL_Cat_ID=AF793A59-B736-42CB-9E1F-E79D2B9FC358&GDL_Disease_ID=554180E5-387E-4246-9AB9-D29E025D417F

oppo123

zzzyz

我08年的时候打过6个月“佩乐能”没效果，那么以后要是我还抗病毒，还能用干扰素吗？

StephenW

zzzyz 发表于 2011-7-21 20:26
我08年的时候打过6个月“佩乐能”没效果，那么以后要是我还抗病毒，还能用干扰素吗？ ...

我不是医生。这是我个人的意见，如果条件合适，你可以用干扰素治疗。请咨询您的医生。其他在这个论坛也可以为您提供咨询。