インターフェロン治療後C型慢性肝炎患者の長期予後　―ウイルス学的著効例，生化学的著効例と無効例の比較―

To evaluate the prognosis of the sustained biochemical responder after interferon (IFN) therapy, we retrospectively studied 252 chronic hepatitis C patients who were treated with IFN. Patients were divided into four groups: group A, sustained virological responders (n=84); group B,sustained biochemical but not virological responders (n=43); group C, incomplete responders (n=64); group D, non responders (n=61). The levels of several liver function tests were evaluated at the end of the observation period (4.2±1.6 years, mean±SD) compared with those at just before IFN therapy. The levels of cholinesterase, albumin, γ-globulin, zinc sufate turbidity test, platelet count and clearance rate of indocyanine green test improved in group A (p<0.05), became worse in group D (p<0.05) and did not change in group B. The incidence of hepatocellular carcinoma was significantly higher in group D than in group B (p<0.01);Kaplan-Meier method, log-rank test). The hazard ratio for hapatocarcinogenesis of the patients in group A and B was significantly lower than that in group C and D (hazard ratio: 0.27, range of 0.08-0.98; p=0.046) adjusted for age, gender, stage and total alcohol consumption. These results suggest that the progress of liver disease and liver carcinogenesis was more suppressed in sustained biochemical responders than in non reponders.

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