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聚乙二醇干扰素 alfa-2a 治疗慢性乙型肝炎 HBeAg 阴性和 E 基因型患者的疗程延长:回顾性分析。

Extended duration of treatment with peginterferon alfa-2a in patients with chronic hepatitis B, HBeAg-negative and E genotype: A retrospective analysis.

机构信息

Department of Medical Sciences, Unit of Infectious Diseases, Amedeo di Savoia Hospital, University of Turin, Turin, Italy.

出版信息

J Med Virol. 2018 Jun;90(6):1047-1052. doi: 10.1002/jmv.25038. Epub 2018 Mar 15.

Abstract

An alternative approach in the treatment of chronic hepatitis B (CHB) with pegylated (PEG)-interferon (IFN) is the prolonged course to 96 weeks of therapy, with higher sustained response (SR) than patients treated for 48 weeks. This result was confirmed in patients with CHB and D genotype, while no data are currently available about the prolonged course of PEG-IFN in E genotype. This retrospective analysis reported the role of different treatment duration of PEG-IFN on the SR in patients affected by CHB and E genotype. A total of 86 subjects with CHB and E genotype were considered in this analysis; different treatment durations were: 48 weeks (control group, 41 patients), 72 weeks (25 patients), and 96 weeks (19 patients). Treatment effectiveness was evaluated with sustained response (SR) and serological response. SR was significantly higher in patients who underwent PEG-IFN for 96 weeks in comparison to 48 weeks: 14.6% versus 26.3% (P = 0.016). HBsAg loss rate was 5.3% in patients treated for 96 weeks and 2.4% in the control group. In the multivariate analysis only the 72 and 96 weeks of therapy (OR 2.335, 95% CI 1.550-4.578; P = 0.020 and (OR 3.890, 95% CI 1.991-10.961; P = 0003) were predictive of SR. The extended duration of PEG-IFN course in patients with CHB and genotype E is a promising approach to increase the SR and HBsAg clearance.

摘要

聚乙二醇干扰素(PEG-IFN)治疗慢性乙型肝炎(CHB)的另一种方法是延长疗程至 96 周,与治疗 48 周的患者相比,持续应答(SR)更高。这一结果在 CHB 和 D 基因型患者中得到了证实,而目前尚无关于 E 基因型患者 PEG-IFN 延长疗程的数据。本回顾性分析报告了不同 PEG-IFN 治疗持续时间对 E 基因型 CHB 患者 SR 的影响。本分析共纳入 86 例 CHB 和 E 基因型患者;不同治疗持续时间为:48 周(对照组,41 例)、72 周(25 例)和 96 周(19 例)。采用持续应答(SR)和血清学应答评估治疗效果。96 周治疗的患者 SR 明显高于 48 周治疗的患者:14.6%比 26.3%(P=0.016)。96 周治疗的患者 HBsAg 丢失率为 5.3%,对照组为 2.4%。多变量分析仅显示 72 周和 96 周的治疗(OR 2.335,95%CI 1.550-4.578;P=0.020 和 OR 3.890,95%CI 1.991-10.961;P=0.0003)与 SR 相关。在 E 基因型 CHB 患者中延长 PEG-IFN 疗程是提高 SR 和 HBsAg 清除率的一种有前途的方法。

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