基因型对聚乙二醇化干扰素α-2a治疗的乙肝e抗原阴性患者乙肝表面抗原动力学的影响。

Influence of genotype on hepatitis B surface antigen kinetics in hepatitis B e antigen-negative patients treated with pegylated interferon-alpha2a.

作者信息

Moucari Rami, Martinot-Peignoux Michelle, Mackiewicz Vincent, Boyer Nathalie, Ripault Marie-Pierre, Castelnau Corinne, Leclere Laurence, Dauvergne Agnes, Valla Dominique, Vidaud Michel, Nicolas-Chanoine Marie-Hélène, Marcellin Patrick

机构信息

AP-HP, Hôpital Beaujon, Service d'Hépatologie, Clichy, France.

出版信息

Antivir Ther. 2009;14(8):1183-8. doi: 10.3851/IMP1458.

DOI:10.3851/IMP1458

PMID:20032548

Abstract

BACKGROUND

The aim of this study was to assess the influence of hepatitis B virus (HBV) genotypes on serum hepatitis B surface antigen (HBsAg) kinetics in hepatitis B e antigen (HBeAg)-negative patients treated with pegylated interferon-alpha2a (PEG-IFN-alpha2a).

METHODS

A total of 48 consecutive patients treated with PEG-IFN-alpha2a (180 microg/week) for 48 weeks were assessed. HBV genotype was determined. Serum HBV DNA and HBsAg were assessed at baseline, during treatment (weeks 12, 24 and 48) and during follow-up (weeks 72 and 96).

RESULTS

The distribution of HBV genotype was A 27%, B 17%, C 12%, D 29% and E 14%. Mean +/-sd pretreatment serum HBV DNA (6.9 +/-1.5 log(10) copies/ml) was not different between genotypes and decreased under treatment in all genotypes without significant difference. Mean +/-sd pretreatment serum HBsAg (3.6 +/-0.6 log(10) IU/ml) was significantly different between genotypes (P<0.001), with high levels in genotypes A and C, intermediate levels in genotypes D and E, and low levels in genotype B (4.0 +/-0.3, 4.1 +/-0.7, 3.6 +/-0.5, 3.6 +/-0.4 and 2.7 +/-0.6 log(10) IU/ml, respectively). Serum HBsAg decreased under treatment in all genotypes with a significant difference. At the end of treatment, mean +/-sd decrease was high in genotype A, intermediate in genotypes B and D, and low in genotypes C and E (1.3 +/-1.6, 0.7 +/-0.7, 0.6 +/-0.9, 0.4 +/-1.0 and 0.4 +/-0.9 log(10) IU/ml, respectively; P<0.001). During follow-up, serum HBsAg continued to decrease in genotypes A and D, whereas rebound was observed in genotypes B, C and E.

CONCLUSIONS

HBV genotype has a strong influence on serum HBsAg kinetics during PEG-IFN-alpha2a therapy in HBeAg-negative patients.

摘要

背景

本研究旨在评估乙型肝炎病毒（HBV）基因型对接受聚乙二醇化干扰素α2a（PEG-IFN-α2a）治疗的乙肝e抗原（HBeAg）阴性患者血清乙肝表面抗原（HBsAg）动力学的影响。

方法

共评估了48例连续接受PEG-IFN-α2a（180μg/周）治疗48周的患者。确定HBV基因型。在基线、治疗期间（第12、24和48周）以及随访期间（第72和96周）评估血清HBV DNA和HBsAg。

结果

HBV基因型分布为：A型27%，B型17%，C型12%，D型29%，E型14%。各基因型之间治疗前血清HBV DNA的平均值±标准差（6.9±1.5 log₁₀拷贝/ml）无差异，且所有基因型在治疗期间均下降，无显著差异。各基因型之间治疗前血清HBsAg的平均值±标准差（3.6±0.6 log₁₀IU/ml）有显著差异（P<0.001），A型和C型水平高，D型和E型水平中等，B型水平低（分别为4.0±0.3、4.1±0.7、3.6±0.5、3.6±0.4和2.7±0.６ log₁₀IU/ml）。所有基因型在治疗期间血清HBsAg均下降，且有显著差异。治疗结束时，A型平均下降值±标准差高，B型和D型中等，C型和E型低（分别为1.3±1.6、0.7±0.7、0.６±0.9、0.4±1.0和0.4±0.9 log₁₀IU/ml；P<0.001）。随访期间，A型和D型血清HBsAg持续下降，而B型、C型和E型出现反弹。