Li Ming-hui, Xie Yao, Wu Yun-zhong, Xu Dao-zhen, Lu Zhi-meng, Hou Jin-lin, Jia Ji-dong, Wang Yu-ming, Zhang Shu-lin, Ren Hong, Chen Xin-Yue
Beijing Ditan Hospital, Beijing 100011, China.
Zhonghua Gan Zang Bing Za Zhi. 2007 Jul;15(7):481-4.
The aim of this paper was to investigate the factors associated with viral response and HBeAg seroconversion and the relationship between them at different stages of interferon treatment in HBeAg-positive chronic hepatitis B patients.
PEG-IFN alfa-2a was injected subcutaneously in doses of 180 microg once a week for 48 weeks to HBeAg-positive chronic hepatitis B patients, and the patients were followed for another 24 weeks after the treatment. The serum HBV DNA load was measured by real-time quantitative PCR assay. Microparticle enzyme immunoassay analysis (MEIA) was then carried out by an automatic enzyme immunoassay analysis instrument to measure HBeAg and anti-HBe. Virological response and HBeAg seroconversion rates, and the factors associated with them were analyzed.
The differences in ALT baselines between viral responding and non-responding groups were significant at treatment time and at the end of the follow-up period. These differences were also significant in patients with HBeAg seroconversion at 12 weeks and at the end of the follow-up period compared with the non-conversion group. No significant difference of HBV DNA baseline was observed between the HBeAg seroconversion and non-conversion group. At 12, 24 and 48 weeks, in patients with viral response during the treatment, their HBeAg seroconversion rates were 43.8%, 21.4% and 18.9% respectively; their respective HBeAg seroconversion rates remaining at 72 weeks were 42.9%, 33.3% and 27.6%. HBeAg seroconversion was related to HBV DNA negativity at 48 weeks treatment in the multivariate analysis (OR=2.15, 95.0% CI=1.744-2.664, P less than 0.01).
Viral response and early and sustained HBeAg seroconversion were associated with pretreatment ALT levels. HBeAg seroconversion was related to viral response during IFN treatment, but not to the baseline HBV DNA load.
本文旨在研究HBeAg阳性慢性乙型肝炎患者在干扰素治疗不同阶段与病毒应答及HBeAg血清学转换相关的因素以及它们之间的关系。
对HBeAg阳性慢性乙型肝炎患者皮下注射聚乙二醇干扰素α-2a，剂量为180微克，每周1次，共48周，治疗后再随访24周。采用实时定量PCR法检测血清HBV DNA载量。然后通过自动酶免疫分析仪器进行微粒体酶免疫分析（MEIA）以检测HBeAg和抗-HBe。分析病毒学应答和HBeAg血清学转换率以及与之相关的因素。
病毒应答组与无应答组在治疗时及随访期末ALT基线差异有统计学意义。与未转换组相比，在12周及随访期末HBeAg血清学转换患者的这些差异也有统计学意义。HBeAg血清学转换组与未转换组之间HBV DNA基线无显著差异。在12、24和48周时，治疗期间有病毒应答的患者其HBeAg血清学转换率分别为43.8%、21.4%和18.9%；在72周时其各自的HBeAg血清学转换率分别为42.9%、33.3%和27.6%。多因素分析显示，治疗48周时HBeAg血清学转换与HBV DNA阴性相关（OR=2.15，95.0%CI=1.744-2.664，P<0.01）。
病毒应答以及早期和持续的HBeAg血清学转换与治疗前ALT水平相关。HBeAg血清学转换与干扰素治疗期间的病毒应答有关，但与基线HBV DNA载量无关。
