Lau George K K
Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China.
Liver Int. 2009 Jan;29 Suppl 1:125-9. doi: 10.1111/j.1478-3231.2008.01946.x.
Worldwide, chronic hepatitis B virus infection is a major cause of end-stage liver disease and hepatocellular carcinoma. While the past two decades have brought major advances in the availability of treatments to help delay or prevent these outcomes, treatment of chronic hepatitis B remains a serious challenge. With the recent availability of potent new nucleot(s)ide such as entecavir, tenofovir and telbuvidine, I still use pegylated interferon (PEG-IFN)-alpha for the treatment of chronic HBeAg-positive patients. This is based on its relatively higher effectiveness in restoring the host immune control on viral replication, resulting in sustained diseases remission in a proportion of patients, a finite course of therapy and the absence of viral resistance. The two major hindrances to its wide application are its lack of effectiveness in a large proportion of patients and its side-effect profile. The former shortcoming can be circumvented to a certain extent with the use of response predictor models. Recently, based on long-term follow-up study, the better durability of sustained response further enhances the confidence in the use of PEG-IFN-alpha in chronic HBeAg-positive patients.
在全球范围内，慢性乙型肝炎病毒感染是终末期肝病和肝细胞癌的主要病因。尽管在过去二十年里，有助于延缓或预防这些后果的治疗方法取得了重大进展，但慢性乙型肝炎的治疗仍然是一项严峻挑战。随着强效新型核苷（酸）类药物如恩替卡韦、替诺福韦和替比夫定的出现，我仍使用聚乙二醇化干扰素（PEG-IFN）-α治疗慢性HBeAg阳性患者。这是基于其在恢复宿主对病毒复制的免疫控制方面相对较高的有效性，从而使一部分患者实现疾病持续缓解，疗程有限且不存在病毒耐药性。其广泛应用的两大障碍是在很大一部分患者中缺乏有效性以及副作用情况。前一个缺点可通过使用反应预测模型在一定程度上得到规避。最近，基于长期随访研究，持续反应的更好持久性进一步增强了在慢性HBeAg阳性患者中使用PEG-IFN-α的信心。
