乙肝表面抗原和e抗原对中国HBeAg阳性患者聚乙二醇干扰素α-2b治疗临床反应的预测作用

HBsAg and HBeAg in the prediction of a clinical response to peginterferon α-2b therapy in Chinese HBeAg-positive patients.

作者信息

Yang Song, Xing Huichun, Wang Yuming, Hou Jinlin, Luo Duande, Xie Qing, Ning Qin, Ren Hong, Ding Huiguo, Sheng Jifang, Wei Lai, Chen Shijun, Fan Xiaoling, Huang Wenxiang, Pan Chen, Gao Zhiliang, Zhang Jiming, Zhou Boping, Chen Guofeng, Wan Mobin, Tang Hong, Wang Guiqiang, Yang Yuxiu, Xu Dongping, Dong Peiling, Wang Qixin, Wang Jue, Bognar Fernando A, Xu Daozhen, Cheng Jun

机构信息

Center of Hepatology, Beijing Ditan Hospital, Capital Medical University, No. 8 Jingshun East Street, Chaoyang District, Beijing, 100015, China.

Southwest Hospital Affiliated Third Military Medical University, Shapingba, Chongqing, 400038, China.

出版信息

Virol J. 2016 Oct 28;13(1):180. doi: 10.1186/s12985-016-0640-1.

DOI:10.1186/s12985-016-0640-1

PMID:27793166

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5084370/

Abstract

BACKGROUND

This study aimed to evaluate the predictive values of hepatitis B e antigen (HBeAg) and hepatitis B surface antigen (HBsAg) levels in 171 Chinese patients with chronic hepatitis B who received a 48-week course of pegylated interferon alfa-2b therapy at 1.5 mcg/kg.

METHODS

HBsAg, HBeAg, and hepatitis B virus (HBV) DNA levels were measured at baseline and weeks 12, 24, 48, and 72. Clinical responses were defined as a combined response (CR, HBeAg seroconversion [sustained response, SR] combined with HBV DNA level <2,000 IU/mL at week 72). The positive predictive value and negative predictive value were calculated for HBsAg alone and/or combined with HBeAg and HBV DNA at weeks 12 and 24.

RESULTS

Of 171 patients included, 58 (33.9 %) achieved a SR. Of patients who achieved a SR, 33 (56.9 %) achieved a CR. Totally 19.3 % (33/171) patients achieved CR and 80.7 % (138/171) patients did not. Patients with HBsAg <1500 IU/mL at week 12 had a 47.4 % chance of achieving an off-treatment SR and patients with a HBsAg decrease >1.5 logIU/mL at week 12 had a 54.5 % chance. Patients with HBsAg >20,000 IU/mL at weeks 12 and 24 had a 93.8 and 100.0 % chance, respectively, of not achieving a CR. An HBsAg level or changes at weeks 12 and 24, combined with HBeAg or HBV DNA, increased the chance for a SR and CR.

CONCLUSIONS

On-treatment HBsAg quantification, alone or in combination with HBeAg or HBV DNA, predicted off-treatment SR and CR after 48 weeks of PEG-IFNα-2b therapy, and thus, may guide clinicians in making a therapeutic decision to continue or terminate the therapy.

摘要

背景

本研究旨在评估171例接受1.5μg/kg聚乙二醇干扰素α-2b治疗48周的中国慢性乙型肝炎患者的乙肝e抗原（HBeAg）和乙肝表面抗原（HBsAg）水平的预测价值。

方法

在基线、第12、24、48和72周测量HBsAg、HBeAg和乙肝病毒（HBV）DNA水平。临床反应定义为联合反应（CR，HBeAg血清学转换[持续反应，SR]并在第72周时HBV DNA水平<2000 IU/mL）。计算第12周和第24周时单独的HBsAg和/或与HBeAg及HBV DNA联合的阳性预测值和阴性预测值。

结果

纳入的171例患者中，58例（33.9%）实现了持续反应。在实现持续反应的患者中，33例（56.9%）实现了联合反应。总计19.3%（33/171）的患者实现了联合反应，80.7%（138/171）的患者未实现。第12周时HBsAg<1500 IU/mL的患者有47.4%的机会实现停药后持续反应，第12周时HBsAg下降>1.5 logIU/mL的患者有54.5%的机会。第12周和第24周时HBsAg>20000 IU/mL的患者分别有93.8%和100.0%的机会未实现联合反应。第12周和第24周时的HBsAg水平或变化，与HBeAg或HBV DNA联合，增加了实现持续反应和联合反应的机会。