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阿德福韦酯作为聚乙二醇化干扰素α-2a治疗HBeAg阳性慢性乙型肝炎患者的附加疗法的短期疗效

[Short-term efficacy of adefovir dipivoxil as an add-on therapy in the pegylated IFNalpha-2a treatment for HBeAg positive chronic hepatitis B patients].

作者信息

Chen Lu-Biao, Shu Xin, Jie Yu-Sheng, Yang Xiao-An, Zhang Ka, Li Gang, Xu Qi-Huan

机构信息

Department of Infectious Diseases, Third Affiliated Hospital of Sun Yet-sen University, Guangzhou, 510630, China.

出版信息

Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2010 Feb;24(1):39-41.

PMID:20848847
Abstract

OBJECTIVE

To investigate whether the combination therapy of pegylated IFNalpha-2a plus adefovir dipivoxil (ADV) improve the efficacy of the treatment in CHB patients with HBeAg positive or not.

METHODS

57 CHB patients with HBeAg positive received 48-week pegylated IFNalpha-2a therapy were enrolled into this study. If serum HBV DNA levels exceeded 1000 copies/ml at week 24, the patients were assigned to group A (pegylated IFN-alpha2a plus ADV, 21 cases) or group B (pegylated IFNalpha-2a only, 14 cases); otherwise, they received the unceasing monotherapy of pegylated IFNalpha-2a (group C, 22 cases).

RESULTS

At week 48, HBeAg seroconversion rates were 23.8%, 28.6% and 63.6% (A vs C,P = 0.014), but rates of aminotransferases normalization and HBV DNA suppression (< 1000 copies/ml) were not statistically significant among three groups. But during week 24 to week 48, rates of HBeAg seroconversion, aminotransferases normalization and HBV DNA suppression were also not statistically significant between group A and B. But amplitude of DNA drop in group A was much more than that in group B (2.60 +/- 1.37 vs 0.86 +/- 2.09, P = 0.005).

CONCLUSION

An ADV add-on therapy in pegylated IFNalpha-2a treatment seems able to improve the inhibition of HBV DNA in chronic hepatitis B patients with HBeAg positive. It requires a large, double-blind, randomized clinical trial to further provent.

摘要

目的

探讨聚乙二醇化干扰素α-2a联合阿德福韦酯(ADV)治疗是否能提高HBeAg阳性或阴性慢性乙型肝炎(CHB)患者的治疗效果。

方法

57例接受48周聚乙二醇化干扰素α-2a治疗的HBeAg阳性CHB患者纳入本研究。若第24周时血清HBV DNA水平超过1000拷贝/ml,则患者被分为A组(聚乙二醇化干扰素α-2a联合ADV,21例)或B组(仅聚乙二醇化干扰素α-2a,14例);否则,他们接受聚乙二醇化干扰素α-2a的持续单药治疗(C组,22例)。

结果

第48周时,HBeAg血清学转换率分别为23.8%、28.6%和63.6%(A组与C组比较,P = 0.014),但三组间转氨酶正常化率和HBV DNA抑制率(<1000拷贝/ml)无统计学意义。但在第24周至第48周期间,A组和B组之间HBeAg血清学转换率、转氨酶正常化率和HBV DNA抑制率也无统计学意义。但A组的DNA下降幅度远大于B组(2.60±1.37对0.86±2.09,P = 0.005)。

结论

聚乙二醇化干扰素α-2a治疗中加用ADV似乎能提高HBeAg阳性慢性乙型肝炎患者对HBV DNA的抑制作用。这需要大规模、双盲、随机临床试验进一步证实。

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引用本文的文献

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CONSORT: Effects of adding adefovirdipivoxil to peginterferon alfa-2a at different time points on HBeAg-positivepatients: A prospective, randomized study.CONSORT:在不同时间点将阿德福韦酯添加到聚乙二醇干扰素α-2a中对HBeAg阳性患者的影响:一项前瞻性随机研究。
Medicine (Baltimore). 2016 Aug;95(31):e4471. doi: 10.1097/MD.0000000000004471.