Department of Infectious Diseases, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Medical Science, Shanghai Roche Pharmaceuticals Ltd., Shanghai, China.
J Viral Hepat. 2019 Jul;26 Suppl 1:5-31. doi: 10.1111/jvh.13150.
Chronic hepatitis B virus (HBV) infection continues to pose a serious global health threat and a significant socio-economic burden in many areas of the world. Almost all current clinical practice guidelines on the management of chronic hepatitis B (CHB) infection recommend that eligible patients pursue the optimal treatment endpoint, which is defined as HBsAg loss with or without anti-HBs seroconversion. This review describes the effects of various regimens containing pegylated interferon (peg-IFN)-alpha on functional cure and the outcome of hepatocellular carcinoma (HCC) in patients with CHB. Peg-IFN-α monotherapy is a treatment option recommended by local and international clinical practice guidelines to help more CHB patients achieve a sustained off-treatment virological response, which is particularly appropriate for relatively young patients who demand a finite treatment approach. Peg-IFN-α add-on or sequential therapy in patients who have achieved a suppressed viral load after nucleos(t)ide analog (NA) therapy may offer further benefits on HBeAg seroconversion and HBsAg decline, although the effects of de novo combination therapy with peg-IFN-α and NAs on long-term outcomes remain unclear. Evaluation of baseline and on-treatment predictors is useful for selecting the patients who are likely to achieve additional benefits. Furthermore, some recent studies have shown that peg-IFN-α-based therapy results in better prevention of HBV-related hepatocellular carcinoma (HCC), especially in high-risk patients.
慢性乙型肝炎病毒（HBV）感染仍然是全球范围内严重的健康威胁和重大社会经济负担，在世界许多地区都存在。几乎所有关于慢性乙型肝炎（CHB）感染管理的现行临床实践指南都建议符合条件的患者追求最佳治疗终点，即 HBsAg 丢失伴或不伴抗-HBs 血清转换。这篇综述描述了含有聚乙二醇干扰素（peg-IFN）-α 的各种方案对 CHB 患者功能性治愈和肝细胞癌（HCC）结局的影响。peg-IFN-α 单药治疗是当地和国际临床实践指南推荐的一种治疗选择，有助于更多 CHB 患者实现持续停药后的病毒学应答，对于需要有限治疗方法的相对年轻患者尤其合适。在核苷（酸）类似物（NA）治疗后病毒载量已被抑制的患者中添加 peg-IFN-α 或序贯治疗可能会进一步促进 HBeAg 血清转换和 HBsAg 下降，但 peg-IFN-α 与 NAs 的新联合治疗对长期结局的影响仍不清楚。评估基线和治疗期间的预测因素有助于选择可能获得额外获益的患者。此外，一些最近的研究表明，peg-IFN-α 为基础的治疗可更好地预防 HBV 相关 HCC，特别是在高危患者中。
