How to heighten the curative effect of interferon?

Guideline of prevention and cure of liver of Chinese chronic second comes on stage more than one year, people cognizant fights virus to treat namely to the standard treatment of chronic second liver, fight virus cure to also have two kinds of plan only, one kind is interferon cure, analogue of a kind of nucleotide is treated. Decide period of treatment and virus mutation than latter inaccuracy, risk of the remedial period of treatment that because its are secured,interferon treats, poisonous without disease mutation and long-term curative effect and the central point that makes second liver domain pay close attention to for a time, however, the short-term curative effect of interferon is smaller the bad-mouth that also calls authority, 2007 on the liver ill forum of New Year beginning, numerous expert discussed actively also how to raise interferon, get together especially glycol interferon α - the curative effect of 2a. Presider is: Australia Bulisi the class is royal hospital Graham Cooksley, participate in discussion expert to basically have: 302 hospital Professor Zhang Hongfei professors of hospital of Beijing ground altar Professor Xu Daozhen, Beijing, China medical university is accessary Chen Xin month teachs hospital of altar of ground of the 2nd hospital Professor Dou Xiaoguang, Beijing and Shanghai is communal and wholesome central witch be apt to. Raising interferon to treat the curative effect field of second liver, each expert thinks the following is very important consistently: 1. The optimal opportunity 　 that chooses treatment although liver of interferon cure second has its distinct advantage, but not be everybody suits interferon to treat, also not be the effect that everybody has interferon is treated identical, accordingly, the remedial opportunity with equal choice is very significant. Immunity is cleared period the optimal opportunity that is cure of interferon disease-resistant poison, and also can obtain best remedial result. Transaminase (ALT) is in go up somehow can struggle between system of reflective airframe immunity and virus state, often state when transaminase is elevatory airframe immunity system is keeping clear of virus, perhaps say to be in cleared period, accordingly, normally clinical go up to basically pass observation transaminase (when does the metabolic decision of ALT) level undertake interferon disease-resistant poison is treated more appropriate. Generally speaking, transaminase is taller, the effect of interferon disease-resistant poison is taller also. Common law is 5 times what ALT> is worth normally, e antigen (rate of HBeAg) serological changeover can be achieved 50% , ALT is in the times E of 2~5 of normal value antigen is serological changeover rate can be achieved 38% , ALT 　 　 2. Lengthen 　 of period of treatment to get together liver of second of glycol interferon cure, get together glycol interferon α - 2a treats excel of 48 weeks of period of treatment 24 weeks of period of treatment, additional, in the respect of cure that monitor, in treating a process E antigen ration monitors serological to monitoring E antigen changeover to lead HBV DNA more valuable, the patient of serological to producing E antigen changeover undertakes exterior antigen (HBsAg) ration is monitored conduce to judgement obtaining exterior antigen whether possibly (HBsAg) serological changeover. Respondent to treating 48 weeks to obtain HBV DNA, but the patient that E antigen has not produced serological changeover lengthens cure to whether can achieve E antigen serological changeover, perhaps obtain E antigen it is OK that the patient of serological changeover continues to treat raise exterior antigen (rate of HBsAg) serum changeover still remains further research and longer observation. 3. Jointly / although current a few research think,order follow in a continuous line treats 　 , the plan that glycol interferon and nucleotide analogue get together jointly in the meantime can not raise E antigen serological changeover rate, but order follow in a continuous line treats plan, use interferon to improve airframe immunity function first especially, follow-up combination therapy may heighten curative effect, and can consider to combine cure to the patient of level of tall HBV DNA before cure, in addition associated therapy may reduce nucleotide kind the virus mutation rate of medicaments, because this is right,combination and the effectiveness that order follow in a continuous line treats still need to undertake further extensive research is discussed. 4. Raise comply with sex, reasonable processing is undesirable reaction 　 gets together glycol interferon α - the conference when 2a is treated appears a few harmful response, the commonnest is blood picture change, if neuter bead cell decreases, if deputy reaction processing is undeserved, or comply with sex of the patient is lower, stop drug blindly, with respect to effect of very inaccessible favorable treatment. Actually, these harmful response basically appear in remedial initial stage, be in commonly 4 fall inside week to lowest, stabilize after that at this one level, after stopping drug, can restore. The neuter bead cell in treating a process decreases to be measured through be being decreased appropriately, lengthen use interval, do not need to stop drug commonly, great majority patient can overshoot. It is the substantial that chronic second liver treats to the proper understanding of harmful response and reasonable processing. Conduce to raise sex of patient comply with. And of interferon enough expose a quantity to be able to heighten clinical curative effect effectively. But in interferon use process. If need of change of thyroid gland function discovers in time and harmful to oneself immunity response undertakes be handlinged effectively. Brief summary 　 is in clinical practice, use get together glycol interferon α - when 2a treats patient of liver of second of E antigen positive, ought to treat an opportunity suitably through the choice, lengthen period of treatment, order follow in a continuous line or associated therapy and the effective processing to harmful response come individual change the ground to heighten clinical curative effect, strive for achieve E antigen serological changeover, later according to exterior antigen (whether does HBsAg) ration drop as a result will consider to whether strive for exterior antigen (HBsAg) serological changeover. (the exercitation edits: Plum apricot)