Unit of Infectious Diseases, University of Turin, Department of Medical Sciences, Amedeo di Savoia Hospital, C.so Svizzera 164, Turin, Italy.
Unit of Infectious Diseases, University of Turin, Department of Medical Sciences, Amedeo di Savoia Hospital, C.so Svizzera 164, Turin, Italy.
J Infect. 2014 Jul;69(1):81-7. doi: 10.1016/j.jinf.2014.02.018. Epub 2014 Mar 14.
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).
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.
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.
The HBV E genotype evidences the worse response to PEG-IFN and maybe requires novel treatment options.
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。
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。
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。
HBV E 基因型对 PEG-IFN 的反应较差，可能需要新的治疗选择。
