[Clinical immunological features and interferon therapy in chronic hepatitis C].
Clinical and immunological findings of 74 patients with chronic hepatitis C have been reported and experiences with interferon-alpha treatment of 31 patients are summarized. In addition, the first results of anti-HCV screening of blood donors are also briefly described. Transfusion in the history was noted in 69% of patients and the time, elapsed from the transfusion to the diagnosis was a mean of 7.15 +/- 8.1 years. Concerning the severity of the liver disease, chronic persistent hepatitis was established in 40%, active hepatitis in 45% and cirrhosis in 15% of the patients, respectively. Cholestasis was recorded in 32% of the cases. A significant elevation of serum immunoglobulin levels was noted in 83%, an antibody to liver specific protein (anti-LSP) has occurred in 80%, cryoglobulinaemia in 44% and circulating immune complexes in 33% of the patients. Natural killer cell activity of peripheral blood mononuclear cells significantly decreased. HLA B8 and DR3 antigens were found with elevated frequency (36.6% and 42.1%). Recombinant interferon-alpha at a weekly dose of 3MU thrice, for six months, has normalized serum alanine aminotransferase in 45% of patients and a sustained remission was found in 26%. The treatment resulted in the clearance of HCV-RNS from the serum in 40% of patients and that well correlated with the complete remission. In the good responders, a decrease in CD4+ cell count and a moderate decrease in CD8+ cell count as well as a transient rise in B cell count were seen during the treatment. Mitogen-induced lymphoproliferative response and natural killer cell activity increased. Predictors of response were as follows: female sex, shorter time elapsed from transfusion, absence of HLA, A1, B8, DR3 and serum anti-HBc negativity. Anti-HCV has been found in 0.33--0.38% of blood donors screened, and it is suggested, that a liver disease accompanied with elevated serum alanine aminotransferase, may be present in about 25-30% of anti-HCV positive symptom-free persons.
Belgyógyászati Klinika, Pécsi Orvostudományi Egyetem I.
A
A
Pár
M
M
Paál
A
A
Gógl
J
J
Gervain
J
J
Szekeres
J
J
Sipos
T
T
Beró
E
E
Hütter
G
G
Berencsi
I
I
Kádas
D000293:Adolescent; D000328:Adult; D000368:Aged; D001803:Blood Transfusion; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006526:Hepatitis C / Q000188:drug therapy / Q000276:immunology*; D006521:Hepatitis, Chronic / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D007136:Immunoglobulins / Q000097:blood; D007370:Interferon Type I / Q000627:therapeutic use*; D007694:Killer Cells, Natural / Q000276:immunology; D008297:Male; D008565:Membrane Proteins / Q000276:immunology; D008875:Middle Aged; D008934:Mitogens; D011994:Recombinant Proteins; D012737:Sex Factors
D007136:Immunoglobulins; D007370:Interferon Type I; D008565:Membrane Proteins; D008934:Mitogens; D011994:Recombinant Proteins
Klinikai immunológiai megfigyelések és interferon terápia krónikus C hepatitisben.