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Factors which affect the results of modulation of host immune response in the treatment of chronic active hepatitis were studied. The efficacy of the treatment was evaluated by means of liver function tests such as serum albumin, SGOT, ICG retension rate, TTT, and serum r-globulin levels. Clinical improvement after treatment with steroid, or steroid and azathioprine, was found in 21 cases (the steroid effective group) out of 34 cases, but not in 13 cases (the steroid ineffective group). Between the effective group and the ineffective group, none of the followings was different: distribution in ages, sex ratio, severity in histological findings in liver tissues obtained by needle biopsy, serum r-globulin levels, and prevalence of HBs antigen in serum. Complications such as steroid diabetes were occurred with similar frequency in both groups. However, HLA-Bw54 were found in 8 out of 19 cases in the effective group in contrast to 1 out of 13 cases in the ineffective group. The frequency of Bw54 was statistically different between the two groups. Levamisole was used in the treatment of 12 cases containing 3 cases of the steroid effective group and 4 cases of the steroid ineffective group. Clinical improvement after treatment with levamisole was found in 3 out of 4 cases of the steroid ineffective group, but not in any of 3 cases of the steroid effective group. It was suggested that no less than two kinds of immunological deterioration might be involved in the development of chronic active hepatitis, and that the clarification of the immunological deterioration was important for control of inflammation of chronic active hepatitis with modulation of host immune response.
財団法人日本消化器病学会の論文

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