Chen Lu-Biao, Shu Xin, Jie Yu-Sheng, Yang Xiao-An, Zhang Ka, Li Gang, Xu Qi-Huan
Department of Infectious Diseases, Third Affiliated Hospital of Sun Yet-sen University, Guangzhou, 510630, China.
Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2010 Feb;24(1):39-41.
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.
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).
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).
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.
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。
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)。
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)。
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。