The clinical significance of serum procollagen type III peptide, a marker of active fibrogenesis, was evaluated in 110 hepatitis B surface antigen positive patients with chronic hepatitis (32 chronic persistent hepatitis, 60 chronic active hepatitis, and 18 active cirrhosis), selected on the basis of active viral replication and biochemical activity, including 54 cases treated with interferon-α. At presentation the procollagen type III peptide level serum was above normal in 48 (44) of the 110 patients and the median value was significantly higher than that of healthy carriers with normal transaminases and histology (P<0.000005). Semiquantitative histological evaluation showed a significant correlation between serum procollagen type III peptide levels and necrosis/inflammation in the subgroup of patients with chronic active hepatitis, but no relationship with the score of fibrosis. Among patients treated with interferon-α and with increased fibrogenic activity (indicated by high pretreatment serum levels of procollagen type III peptide), peptide levels were significantly decreased when pretreatment levels were compared with those at 12 months after therapy withdrawal, both in responders to interferon (P=0.022) and non-responders (P=0.012). However, serum procollagen type III peptide levels normalized in 75 of responders to interferon with sustained serological and histological remission of liver disease, but in only 21 of non-responders (P=0.02). These results obtained in a well-defined population suggest that serum procollage type III peptide is a better marker of active fibrogenesis and inflammation than an indicator of the extent of fibrosis, and that interferon may reduce active liver fibrogenesis in chronic hepatitis B indenpendently of its effect on viral replication. However, a consistent proportion (56) of our chronic hepatitis B patients had normal serum procollagen type III peptide levels at presentation, thus precluding the clinical use of this marker both for diagnosis of liver injury and for monitoring the therapeutic response to interfero
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机译：以干扰素-α治疗的54例患者为研究对象，评价了110例乙型肝炎表面抗原阳性慢性肝炎患者（32例慢性持续性肝炎、60例慢性活动性肝炎、18例活动性肝硬化）的临床意义。就诊时，110 例患者中有 48 例 （44%） 的血清前胶原 III 型肽水平高于正常值，中位值显著高于转氨酶和组织学正常的健康携带者 （P<0.000005）。半定量组织学评估显示，慢性活动性肝炎患者亚组血清III型前胶原肽水平与坏死/炎症有显著相关性，但与纤维化评分无相关性。在接受干扰素-α治疗且纤维活性增加的患者中（表现为治疗前血清前III型前胶原水平高），与治疗后12个月的治疗前水平相比，干扰素反应者（P=0.022）和无反应者（P=0.012）的肽水平显著降低。然而，75% 的干扰素反应者血清 III 型前胶原肽水平正常，肝病血清学和组织学持续缓解，但只有 21% 的无反应者 （P=0.02）。在明确定义的人群中获得的这些结果表明，血清前胶合III型肽是活动性纤维化和炎症的更好标志物，而不是纤维化程度的指标，并且干扰素可以减少慢性乙型肝炎中活动性肝纤维化对病毒复制的影响。然而，我们的慢性乙型肝炎患者中有一致比例（56%）在就诊时血清III型前胶原肽水平正常，因此排除了该标志物在临床上用于肝损伤诊断和监测对干扰的治疗反应
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