乙型肝炎 E 基因型：临床和病毒学特征，以及对干扰素的反应。

The E genotype of hepatitis B: clinical and virological characteristics, and response to interferon.

机构信息

Unit of Infectious Diseases, University of Turin, Department of Medical Sciences, Amedeo di Savoia Hospital, C.so Svizzera 164, Turin, Italy.

出版信息

J Infect. 2014 Jul;69(1):81-7. doi: 10.1016/j.jinf.2014.02.018. Epub 2014 Mar 14.

DOI:10.1016/j.jinf.2014.02.018

PMID:24631900

Abstract

OBJECTIVES

10 hepatitis B virus (HBV) genotypes are known with different geographic distribution and response to interferon (IFN) therapy. The E genotype is the more prevalent genotype in West and Central Africa, but few data about response to IFN are available. We describe the epidemiological and clinical characteristics in a cohort of patients immigrants from Africa in our country with HBV E genotype chronic hepatitis infection (CHB).

METHODS

63 patients with CHB and E genotype were included; 41 with CHB and low viral load were treated with PEG-IFN monotherapy; 10 with CHB and high viral load with sequential approach (entecavir and PEG-IFN). 12 patients with inactive CHB were followed with blood sample and abdomen ultrasonography every six months.

RESULTS

The virological response in the monotherapy group was 17.9%. Hepatitis B surface antigen (HBsAg) loss was observed in 1 patient (2.5%); 56 patients (88%) showed at the time of diagnosis of CHB another infectious diseases that required specific treatment before PEG-IFN; this treatment was also affected by an higher incidence of side-effects (>50%). All patients with high viremia showed a primary non-response to PEG-IFN.

CONCLUSIONS

The HBV E genotype evidences the worse response to PEG-IFN and maybe requires novel treatment options.

摘要

目的

已知有 10 种乙型肝炎病毒（HBV）基因型，其分布和对干扰素（IFN）治疗的反应各不相同。E 基因型是西非和中非更为常见的基因型，但关于其对 IFN 反应的数据很少。我们描述了来自非洲的移民患者中乙型肝炎病毒 E 基因型慢性乙型肝炎感染（CHB）患者的流行病学和临床特征。

方法

纳入了 63 例 CHB 和 E 基因型患者；41 例低病毒载量的 CHB 患者接受 PEG-IFN 单药治疗；10 例高病毒载量的 CHB 患者采用序贯治疗（恩替卡韦和 PEG-IFN）。12 例非活动期 CHB 患者每 6 个月进行一次血液样本和腹部超声检查。

结果

单药治疗组的病毒学应答率为 17.9%。1 例（2.5%）患者出现乙型肝炎表面抗原（HBsAg）丢失；56 例（88%）患者在诊断为 CHB 时还患有其他需要在接受 PEG-IFN 治疗前进行特异性治疗的传染病；这种治疗也受到副作用发生率较高（>50%）的影响。所有高病毒血症患者对 PEG-IFN 均表现为原发性无应答。