Chen Gong-Ying, Zhu Meng-Fei, Zheng Da-Liang, Bao Yan-Ting, Wang Jie, Zhou Xiang, Lou Guo-Qiang
Gong-Ying Chen, Meng-Fei Zhu, Jie Wang, Guo-Qiang Lou, Hospital Affiliated to Hangzhou Normal University, Hangzhou 310015, Zhejiang Province, China.
World J Gastroenterol. 2014 Jul 7;20(25):8195-200. doi: 10.3748/wjg.v20.i25.8195.
To evaluate the predictive effect of baseline hepatitis B surface antigen (HBsAg) on response to pegylated interferon (PEG-IFN)-α2b in hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) patients.
This retrospective analysis compared the treatment efficacy of PEG-IFN-α2b alone in 55 HBeAg-positive CHB patients with different baseline HBsAg levels. Serum HBV DNA load was measured at baseline, and at 12, 24 and 48 wk of therapy. Virological response was defined as HBV DNA < 1000 IU/mL. Serum HBsAg titers were quantitatively assayed at baseline, and at 12 and 24 wk.
Eighteen patients had baseline HBsAg > 20 000 IU/mL, 26 patients had 1500-20000 IU/mL, and 11 patients had < 1500 IU/mL. Three (16.7%), 11 (42.3%) and seven (63.6%) patients in each group achieved a virological response at week 48, with a significant difference between groups with baseline HBsAg levels > 20000 or < 20000 IU/mL (P = 0.02). Thirteen patients had an HBsAg decline > 0.5 log10 and 30 patients < 0.5 log10 at week 12; and 6 (46.2%) and 10 (33.3%) in each group achieved virological response at week 48, with no significant difference between the two groups (P = 0.502). Eighteen patients had an HBsAg decline > 1.0 log10 and 30 patients < 1.0 log10 at week 24, and 8 (44.4%) and 11 (36.7%) achieved a virological response at week 48, with no significant difference between the two groups (P = 0.762). None of the 16 patients with HBsAg > 20000 IU/mL at week 24 achieved a virological response at week 48.
Baseline HBsAg level in combination with HBV DNA may become an effective predictor for guiding optimal therapy with PEG-IFN-α2b against HBeAg-positive CHB.
评估基线乙型肝炎表面抗原（HBsAg）对乙型肝炎e抗原（HBeAg）阳性慢性乙型肝炎（CHB）患者聚乙二醇干扰素（PEG-IFN）-α2b治疗反应的预测作用。
这项回顾性分析比较了55例不同基线HBsAg水平的HBeAg阳性CHB患者单独使用PEG-IFN-α2b的治疗效果。在基线、治疗12周、24周和48周时检测血清HBV DNA载量。病毒学应答定义为HBV DNA<1000 IU/mL。在基线、12周和24周时对血清HBsAg滴度进行定量检测。
18例患者基线HBsAg>20000 IU/mL，26例患者为1500 - 20000 IU/mL，11例患者<1500 IU/mL。每组中分别有3例（16.7%）、11例（42.3%）和7例（63.6%）患者在48周时达到病毒学应答，基线HBsAg水平>20000或<20000 IU/mL的组间差异有统计学意义（P = 0.02）。13例患者在12周时HBsAg下降>0.5 log10，30例患者<0.5 log10；每组中分别有6例（46.2%）和10例（33.3%）患者在48周时达到病毒学应答，两组间差异无统计学意义（P = 0.502）。18例患者在24周时HBsAg下降>1.0 log10，30例患者<1.0 log10，分别有8例（44.4%）和11例（36.7%）患者在48周时达到病毒学应答，两组间差异无统计学意义（P = 0.762）。24周时HBsAg>20000 IU/mL的16例患者中无1例在48周时达到病毒学应答。
基线HBsAg水平联合HBV DNA可能成为指导PEG-IFN-α2b治疗HBeAg阳性CHB最佳治疗方案的有效预测指标。
