Treatment of HBeAg-positive chronic hepatitis with short-term prednisolone withdrawal and combination of it with Ara-A.

概要

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Sixteen patients with HBeAg-positive chronic hepatitis were treated with short-term prednisolone withdrawal alone and in combination with oral Ara-A Subseqently. HBV-DNA polymerase activity levels showed the marked increases to 6, 735.1±2, 635.8cpm (mean±SEM) from 1, 732.1±896.1cpm at the pretreatment, and decreased again. Serum GPT levels were transiently suppressed at 3 or 4 weeks after the beginning of treatment and remarkable elevation (rebound) to 687.1±375.1IU/1 were followed in 6 cases. HBeAg became negative in 6 cases (37.5%) within 6 months and 9 cases (56.0%) within 12 nonths. It is high incidence rate compared with untreated 10 patients with chronic type B hepatitis. The younger patients with higher DNA-P activity and SGPT showed higher incidence for seroconversion to anti-HBe from HBeAg. Rapid withdrawal method was more effective than gradual withdrawal, and subseqent oral Ara-A induced the long-term remission in chornic type B hepatitis. These results suggest that short-term prednisolone withdrawal and Ara-A in combination therapy is adequate to induce permanent effectiveness for HBV infection.