Mao Qian-guo, Luo Kang-xian, Zhang Ming-xia, Liu DinglLi, Hou Jin-lin
Department of Infectious Diseases, Nanfang Hospital, First Military Medical University, Guangzhou 510515, China.
Di Yi Jun Yi Da Xue Xue Bao. 2003 Dec;23(12):1319-22.
To investigate the generation of neutralizing anti-interferon-alpha antibodies (NA) in patients with chronic hepatitis B in the course of interferon-alpha treatment, and analyze the factors influencing the production of the antibodies.
A total of 181 patients with histologically confirmed chronic hepatitis B were enrolled in this study. Recombinant interferon-alpha 1b (rIFN-alpha 1b) was given subcutaneously 3 times a week (5 MU once) in a treatment course lasting for 6 to 37 months (median 10.0 months). In each case, serum NA was detected with antiviral neutralization bioassay, HBeAg with enzyme-linked immunoassay (EIA) and hepatitis B virus DNA with fluorescent quantitative PCR every 1 to 3 months starting from 3 months after the initiation of the treatment.
Of the 181 patients, 61 were positive for NA during the treatment course, resulting in an overall NA occurrence rate of 33.7%. The overall incidence rate, as well as the overall prevalence rate, was significantly higher in male than in female patients (39.1% vs 20.8%, (2)=5.622, P=0.018), and no correlations of NA generation was observed with age, pretreatment serum ALT level, serum HBeAg, serum HBV DNA level, liver histological findings or treatment course. Binary logistic regression analysis showed that the only factor in relation with NA production was gender. The prevalence rates of NA varied significantly with the treatment courses ( (2)=98.051, P=0.000). Bivariate correlation analysis showed that the prevalence rate of NA, but not the incidence of NA, was strongly related with the treatment course (r=0.855, P<0.001).
In chronic hepatitis B patients treated with rIFN-alpha 1b, the prevalence rate of NA, instead of the incidence of NA, is significantly related to the treatment course. NA was more likely to develop in male patients to contribute to their poorer antiviral response in comparison with the female patients.
探讨慢性乙型肝炎患者在干扰素-α治疗过程中中和性抗干扰素-α抗体(NA)的产生情况,并分析影响抗体产生的因素。
本研究共纳入181例经组织学确诊的慢性乙型肝炎患者。重组干扰素-α1b(rIFN-α1b)每周皮下注射3次(每次5MU),疗程持续6至37个月(中位时间10.0个月)。从治疗开始3个月起,每1至3个月对每例患者用抗病毒中和生物测定法检测血清NA,用酶联免疫吸附测定法(EIA)检测HBeAg,用荧光定量PCR检测乙型肝炎病毒DNA。
181例患者中,61例在治疗过程中NA呈阳性,总体NA发生率为33.7%。男性患者的总体发生率和总体患病率均显著高于女性患者(39.1%对20.8%,χ²=5.622,P=0.018),未观察到NA产生与年龄、治疗前血清ALT水平、血清HBeAg、血清HBV DNA水平、肝脏组织学检查结果或疗程之间存在相关性。二元逻辑回归分析显示,与NA产生相关的唯一因素是性别。NA的患病率随疗程有显著变化(χ²=98.051,P=0.000)。双变量相关分析显示,NA的患病率而非发生率与疗程密切相关(r=0.855,P<0.001)。
在接受rIFN-α1b治疗的慢性乙型肝炎患者中,NA的患病率而非发生率与疗程显著相关。与女性患者相比,男性患者更易产生NA,导致其抗病毒反应较差。