ALT水平维持正常的慢性丙型肝炎患者抗病毒治疗中的病毒动力学

作     者：Kronenberger B. Herrmann E. Micol F. et al. S. Zeuzem 翟惠虹 

作者机构：Klinik für Innere Medizin II Universitatsklinikum des Saarlandes Kirrberger Strasse D-66421 Homburg/Saar Germany Dr. 

出 版 物：《世界核心医学期刊文摘（胃肠病学分册）》 (Core Journals in Gastroenterology)

年 卷 期：2005年第1卷第5期

页      面：38-39页

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 100401[医学-流行病与卫生统计学] 10[医学] 

主　　题：慢性丙型肝炎 ALT水平 抗病毒 干扰素α 丙型肝炎患者 丙氨酸转氨酶 拟合值 感染细胞 定量的 转肽酶 

摘      要：The aim of the present study was to compare viral kinetics between patients with chronic hepatitis C and persistently normal alanine aminotransferase (ALT) levels and those with elevated ALT levels. Kinetic parameters were derived from nonlinear, least square fitting of serum hepatitis C virus RNA quantifications collected from patients with chronic hepatitis C and persistently normal (n = 20) and elevated (n = 19) ALT levels before and during treatment with 180 μg pegylated interferon α-2a once weekly plus daily ribavirin. Patients with chronic hepatitis C and persistently normal ALT levels showed a trend to lower pre-treatment infected cell loss (δ) (P = .13) but no differences in efficacy of blocking virus production (ε)and infected cell loss during treatment (mδ) compared with patients with elevated ALT levels. Differences were significant for ε(P = .02) and δ(P = .04) when applying updated “healthylevels for ALT (0.75 times and 0.63 times upper limit of normal for male and female patients, respectively). A significant reduction of the kinetic parameters , δ,and mδwas observed in patients with elevated γ-glutamyltranspeptidase (GGT) levels compared with patients with normal GGT levels (P = .02, P = .005, and P = .02, respectively). In conclusion, viral kinetics are similar in patients with chronic hepatitis C and persistently normal ALT levels and those with elevated ALT levels. However, in patients with elevated GGT levels, a major association with reduced efficacy of blocking virus production and lower infected cell loss was observed. These data show that virological response in patients with chronic hepatitis C is less associated with baseline ALT than with GGT levels.