Sonneveld Milan J, Zoutendijk Roeland, Hansen Bettina E, Janssen Harry L A
Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
Antivir Ther. 2012;17(8):1605-8. doi: 10.3851/IMP2319. Epub 2012 Aug 16.
Hepatitis B e antigen (HBeAg) and hepatitis B surface antigen (HBsAg) clearance are associated with an improved prognosis in chronic hepatitis B (CHB) patients. These end points are more often achieved with a one-year course of pegylated interferon (PEG-IFN) compared with one year of nucleoside/nucleotide analogue therapy. However, prolonged nucleoside/nucleotide analogue therapy may result in comparable serological response rates as with PEG-IFN.
We compared serological and virological response rates among HBeAg-positive CHB patients treated with long-term continuous entecavir (ETV; n=91) for a median of 92 (IQR 50-132) weeks or one year of PEG-IFN (n=266) with comparable follow-up.
Median follow-up was 92 weeks (IQR 78-198) for patients treated with PEG-IFN and 92 weeks (IQR 50-132) for patients treated with ETV. Finite PEG-IFN therapy resulted in significantly higher rates of HBeAg seroconversion (adjusted hazard ratio [HR] 3.16; P<0.001) and HBsAg clearance (HR 5.66; P=0.027) when compared to prolonged ETV treatment, whereas, ETV resulted in higher rates of HBV DNA undetectability (OR 31.14; P<0.001) also after adjustment for HBV genotype and other relevant baseline factors.
Our study shows that finite PEG-IFN is associated with a higher probability of serological, but not virological, response for HBeAg-positive CHB patients when compared to prolonged ETV, even after correction for baseline differences.
乙肝e抗原（HBeAg）和乙肝表面抗原（HBsAg）清除与慢性乙型肝炎（CHB）患者预后改善相关。与核苷/核苷酸类似物治疗一年相比，聚乙二醇干扰素（PEG-IFN）治疗一年更常达到这些终点。然而，延长核苷/核苷酸类似物治疗可能导致与PEG-IFN相当的血清学应答率。
我们比较了长期持续使用恩替卡韦（ETV；n = 91）治疗中位数为92（四分位间距50 - 132）周的HBeAg阳性CHB患者与接受一年PEG-IFN（n = 266）治疗且随访时间相当的患者的血清学和病毒学应答率。
接受PEG-IFN治疗的患者中位随访时间为92周（四分位间距78 - 198），接受ETV治疗的患者为92周（四分位间距50 - 132）。与延长ETV治疗相比，有限疗程的PEG-IFN治疗导致HBeAg血清学转换率（校正风险比[HR] 3.16；P < 0.001）和HBsAg清除率（HR 5.66；P = 0.027）显著更高，而在对HBV基因型和其他相关基线因素进行校正后，ETV导致HBV DNA不可检测率更高（比值比31.14；P < 0.001）。
我们的研究表明，对于HBeAg阳性CHB患者，与延长ETV治疗相比，有限疗程的PEG-IFN即使在校正基线差异后，血清学应答概率更高，但病毒学应答概率并非如此。
