Tamai Hideyuki, Ida Yoshiyuki, Shingaki Naoki, Shimizu Ryo, Fukatsu Kazuhiro, Itonaga Masahiro, Yoshida Takeichi, Maeda Yoshimasa, Moribata Kosaku, Maekita Takao, Iguchi Mikitaka, Kato Jun, Kitano Masayuki
Second Department of Internal Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama 641-0012, Japan.
Hepat Res Treat. 2017;2017:2093847. doi: 10.1155/2017/2093847. Epub 2017 Apr 11.
Entecavir requires long-term administration. Pegylated interferon (PEG-IFN) therapy leads to significant reduction of hepatitis B surface antigen (HBs Ag) levels. This study aimed to assess the safety and efficacy of adding PEG-IFN--2a to entecavir toward cessation of entecavir. A total of 23 patients treated with entecavir underwent add-on PEG-IFN--2a therapy (90 g per week) for 48 weeks. Viral response (VR) was defined as more than 50% reduction of baseline hepatitis B surface antigen (HBs Ag) level at 72 weeks from the start of therapy. Complete response (CR) was defined as the decline of HBs Ag levels <100 IU/mL. Hepatitis B e antigen (HBe Ag) seroconversion rate was 25% (2/8), and VR rate was 52% (12/23). CR was observed in four patients (17%). However, CR rate in baseline HBs Ag level <2000 IU/mL and HBe Ag negative patients was 50% (4/8). Univariate analysis showed that the percentage of HBs Ag level reduction at week 12 was significantly associated with VR. The area under the curve value was 0.848. Adding PEG-IFN--2a to entecavir has limited efficacy. The percentage reduction of HBs Ag level at week 12 may be a useful predictor for VR.
恩替卡韦需要长期服用。聚乙二醇干扰素（PEG-IFN）治疗可显著降低乙肝表面抗原（HBs Ag）水平。本研究旨在评估在恩替卡韦基础上加用PEG-IFN-α2a以停用恩替卡韦的安全性和疗效。共有23例接受恩替卡韦治疗的患者接受了为期48周的PEG-IFN-α2a（每周90μg）附加治疗。病毒学应答（VR）定义为治疗开始后72周时基线乙肝表面抗原（HBs Ag）水平降低超过50%。完全应答（CR）定义为HBs Ag水平下降至<100IU/mL。乙肝e抗原（HBe Ag）血清学转换率为25%（2/8），VR率为52%（12/23）。4例患者（17%）观察到CR。然而，基线HBs Ag水平<2,000IU/mL且HBe Ag阴性患者的CR率为50%（4/8）。单因素分析显示，第12周时HBs Ag水平降低的百分比与VR显著相关。曲线下面积值为0.848。在恩替卡韦基础上加用PEG-IFN-α2a疗效有限。第12周时HBs Ag水平降低的百分比可能是VR的一个有用预测指标。
