轻度急性加重的慢性乙型肝炎的抗病毒治疗

Antiviral Therapy in Chronic Hepatitis B With Mild Acute Exacerbation.

作者信息

Lin Su, Ye Qiaoxia, Wang Mingfang, Wu Yinlian, Weng Zhiyuan, Zhu Yueyong

机构信息

Liver Research Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China.

Liver Research Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China; Clinical Liver Center of the 180th Hospital of People's Liberation Army, Quanzhou 362100, China.

出版信息

Gastroenterology Res. 2017 Feb;10(1):6-14. doi: 10.14740/gr754w. Epub 2017 Feb 21.

DOI:10.14740/gr754w

PMID:28270871

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5330687/

Abstract

BACKGROUND

The aim of this study was to assess the efficacy and safety of peginterferon α-2a (pegIFN) and nucleos(t)ide analogues (NA) treatments in patients with hepatitis B envelope antigen (HBeAg)-positive chronic hepatitis B (CHB) with mild acute exacerbation (AE).

METHODS

Treatment-naive HBeAg-positive CHB patients with AE who received pegIFN or NA (entecavir (ETV) or telbivudine (LDT)) therapies were retrospectively selected. The HBeAg seroconversion rate, hepatitis B surface antigen (HBsAg) loss rate and the cost-effectiveness of different treatments were compared.

RESULTS

A total of 63 patients with pegIFN therapy and 78 with NA (38 with ETV and 40 with LDT) therapy were included. The HBsAg loss rate was significantly higher in the pegIFN group when compared with the NA group (on week 96: 9/63 (14.29%) vs. 1/78 (1.28%), P = 0.005). No significant difference in hepatitis B virus (HBV) DNA negativity or the HBeAg/HBsAg seroconversion rate was found between ETV and LDT group. One year of pegIFN therapy resulted in 18.56 quality-adjusted life years (QALYs) per patient, and the incremental cost per additional QALY gained was $3,709.

CONCLUSIONS

PegIFN therapy is safe in HBeAg-positive CHB patients with mild AE, as it results in a higher HBsAg loss rate and longer QALYs than NA therapy.

摘要

背景

本研究旨在评估聚乙二醇干扰素α-2a（pegIFN）和核苷（酸）类似物（NA）治疗伴有轻度急性加重（AE）的乙肝e抗原（HBeAg）阳性慢性乙型肝炎（CHB）患者的疗效和安全性。

方法

回顾性选取初治的伴有AE的HBeAg阳性CHB患者，这些患者接受了pegIFN或NA（恩替卡韦（ETV）或替比夫定（LDT））治疗。比较不同治疗方法的HBeAg血清学转换率、乙肝表面抗原（HBsAg）消失率及成本效益。

结果

共纳入63例接受pegIFN治疗的患者和78例接受NA（38例接受ETV治疗，40例接受LDT治疗）治疗的患者。pegIFN组的HBsAg消失率显著高于NA组（第96周时：9/63（14.29%）对1/78（1.28%），P = 0.005）。ETV组和LDT组在乙肝病毒（HBV）DNA转阴率或HBeAg/HBsAg血清学转换率方面未发现显著差异。pegIFN治疗1年使每位患者获得18.56个质量调整生命年（QALY），每增加1个QALY所增加的成本为3709美元。