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聚乙二醇干扰素α-2a 和 α-2b 在慢性乙型肝炎患者中的疗效比较。

The comparison of the efficacy of pegylated interferon α-2a and α-2b in chronic hepatitis B patients.

机构信息

Department of Gastroenterology, Adana Numune Training and Research Hospital, Adana, Turkey.

出版信息

Eur J Gastroenterol Hepatol. 2013 Nov;25(11):1312-6. doi: 10.1097/MEG.0b013e328362389a.

Abstract

BACKGROUND/AIM: Although 48-week therapy with pegylated-interferons has been shown to be effective for the treatment of chronic hepatitis B (CHB), comparison of the efficacy of pegylated-interferon α-2a (Peg-IFNα-2a) and Peg-IFNα-2b in the therapy is not obvious. We aimed to compare the efficacy of Peg-IFNα-2a versus Peg-IFNα-2b in the treatment of CHB.

PATIENTS AND METHODS

Fifty-one CHB patients treated with 48 weeks of Peg-IFNα-2a (n=24) and Peg-IFNα-2b (n=27) who had been followed up between 2009 and 2011 at the Liver Clinic of Adana Numune Training and Research Hospital, Turkey, were investigated retrospectively. Six (25%) patients in the Peg-IFNα-2a group and nine (33%) in the Peg-IFNα-2b group were HBeAg-positive. Serum HBV-DNA, HBeAg, and HBsAg values were assessed at baseline. Biochemical and virological responses were evaluated every 12 weeks during the course of the treatment, at the end of the treatment, and follow-up week 24. Sustained virological response (SVR) was defined as sustained inhibition of viral replication (HBV-DNA<10 000 copies/ml) and a normal alanine aminotransaminase level until 24 weeks after treatment. Undetectable HBV-DNA was considered as less than 400 copies/ml.

RESULTS

Six of the 24 (25%) patients treated with Peg-IFNα-2a versus eight of the 27 (29.6%) patients treated with Peg-IFNα-2b achieved an SVR (P=0.75). HBeAg seroconversion occurred in three patients only in the Peg-IFNα-2b group. Rates of patients with undetectable HBV-DNA at 24 weeks after a 48-week course of therapy were 20.8% for Peg-IFNα-2a and 22.2% for Peg-IFNα-2b (P=0.82).

CONCLUSION

In CHB, there were no significant differences between Peg-IFNα-2a and Peg-IFNα-2b treatment groups in achieving an SVR and undetectable HBV-DNA levels.

摘要

背景/目的:聚乙二醇干扰素治疗慢性乙型肝炎(CHB)48 周已被证实有效,但聚乙二醇干扰素α-2a(Peg-IFNα-2a)和 Peg-IFNα-2b 的疗效比较尚不明确。本研究旨在比较 Peg-IFNα-2a 与 Peg-IFNα-2b 治疗 CHB 的疗效。

患者与方法

土耳其阿达纳努梅因培训与研究医院肝病科于 2009 年至 2011 年对接受 48 周 Peg-IFNα-2a(n=24)和 Peg-IFNα-2b(n=27)治疗并随访的 51 例 CHB 患者进行回顾性研究。Peg-IFNα-2a 组 6 例(25%)和 Peg-IFNα-2b 组 9 例(33%)患者 HBeAg 阳性。在基线时评估血清 HBV-DNA、HBeAg 和 HBsAg 值。在治疗过程中每 12 周、治疗结束时和随访 24 周时评估生化和病毒学应答。持续病毒学应答(SVR)定义为病毒复制持续抑制(HBV-DNA<10000 拷贝/ml)和治疗后 24 周时丙氨酸氨基转移酶水平正常。HBV-DNA 不可检测定义为<400 拷贝/ml。

结果

Peg-IFNα-2a 组 24 例患者中 6 例(25%)和 Peg-IFNα-2b 组 27 例患者中 8 例(29.6%)获得 SVR(P=0.75)。仅有 Peg-IFNα-2b 组的 3 例患者发生 HBeAg 血清学转换。48 周治疗结束后 24 周时,Peg-IFNα-2a 组和 Peg-IFNα-2b 组的 HBV-DNA 不可检测率分别为 20.8%和 22.2%(P=0.82)。

结论

在 CHB 中,Peg-IFNα-2a 和 Peg-IFNα-2b 治疗组在获得 SVR 和 HBV-DNA 不可检测水平方面无显著差异。

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