[重组干扰素-α治疗男性慢性乙型肝炎患者抗病毒应答不佳的原因研究]

[A study of the causes of poor antiviral responses in male chronic hepatitis B patients treated with recombinant interferon-alpha].

作者信息

Mao Qian-Guo, Liu Ding-Li, Zhang Ming-Xia, Feng Xiao-Rong, Hou Jin-Lin

机构信息

Department of Infectious Diseases, Nanfang Hospital, Nanfang Medical University, Guangzhou 510515, China.

出版信息

Zhonghua Gan Zang Bing Za Zhi. 2005 Jan;13(1):24-6.

PMID:15670486

Abstract

OBJECTIVE

To study the causes of poorer antiviral response to neutralizing anti-interferon-alpha antibodies (NA) in male chronic hepatitis B patients treated with recombinant interferon-alpha (rIFN-alpha).

METHODS

Two hundred sixty-nine patients (198 males and 71 females) with histologically proven chronic hepatitis B were treated with 5 MU recombinant interferon-alpha 1b (rIFN-alpha 1b) subcutaneously thrice weekly for 6-37 (median 10.0) months. For each patient, serum HBV DNA levels were detected with fluorescent-quantitative PCR, HBeAg with enzymoimmunoassay, and NA with an antiviral neutralizing biological assay during therapy.

RESULTS

NA was found in 70 (35.4%) of the 198 males and in 15 (21.1%) of the 71 females during treatment (x2 = 4.894, P = 0.027). At the end of treatment combined-response was achieved in 21 (24.7%) of the 85 NA-positive patients and in 100 (54.3%) of the 184 NA-negative cases (x2 = 20.642). Stratification analysis by NA showed that combined-response rate was significantly lower in males than in females (18.6%, 13/70 vs. 53.3%, 8/15, x2 = 8.024) among NA-positive patients while it was similar in males and in females (50.8%, 65/128, vs. 62.5%, 35/56, x2 = 2.156) among NA-negative patients. In stratification analysis by gender, it was significantly lower in NA-positive patients than in NA-negative ones (18.6%, 13/70 vs. 53.3%, 8/15, x2 = 8.024) among males but there was no significant difference between combined-response rates among females.

CONCLUSION

The poorer antiviral response to recombinant interferon-alpha in male chronic hepatitis B patients than in female patients is related to the neutralizing anti-interferon antibodies.

摘要

目的

研究接受重组干扰素-α（rIFN-α）治疗的男性慢性乙型肝炎患者对抗病毒中和性抗干扰素-α抗体（NA）产生较差抗病毒反应的原因。

方法

269例经组织学证实为慢性乙型肝炎的患者（198例男性，71例女性），接受5MU重组干扰素-α1b（rIFN-α1b）皮下注射，每周3次，共治疗6 - 37（中位值10.0）个月。治疗期间，对每位患者采用荧光定量PCR检测血清HBV DNA水平，酶免疫法检测HBeAg，抗病毒中和生物学试验检测NA。

结果

治疗期间，198例男性患者中有70例（35.4%）检测到NA，71例女性患者中有15例（21.1%）检测到NA（χ² = 4.894，P = 0.027）。治疗结束时，85例NA阳性患者中有21例（24.7%）实现联合反应，184例NA阴性患者中有100例（54.3%）实现联合反应（χ² = 20.642）。按NA进行分层分析显示，NA阳性患者中男性的联合反应率显著低于女性（18.6%，13/70 vs. 53.3%，8/15，χ² = 8.024），而NA阴性患者中男性和女性的联合反应率相似（50.8%，65/128 vs. 62.5%，35/56，χ² = 2.156）。按性别进行分层分析，男性中NA阳性患者的联合反应率显著低于NA阴性患者（18.6%，13/70 vs. 53.3%，8/15，χ² = 8.024），而女性患者的联合反应率之间无显著差异。