Zhang Chong, Yang Zhengrong, Wang Ziyi, Dou Xiaoguang, Sheng Qiuju, Li Yanwei, Han Chao, Ding Yang
Department of Infectious Diseases, Shengjing Hospital of China Medical University, Shenyang, 110022, China.
Int J Med Sci. 2020 Feb 4;17(3):383-389. doi: 10.7150/ijms.39775. eCollection 2020.
: The proportion of hepatitis e antigen (HBeAg)-negative chronic hepatitis B (CHB) patients in China has increased rapidly. However, the response of these patients to peginterferon (peg-IFN) treatment is poor, and the antiviral treatment strategies are inconsistent. This study aimed to investigate the role of hepatitis B virus (HBV) DNA and hepatitis B surface antigen (HBsAg) in early prediction of response in HBeAg-negative CHB patients receiving peg-IFN α-2a. : Treatment-naïve HBeAg-negative patients were involved in this prospective study during 2014-2018. The HBV DNA and HBsAg were quantified at baseline and during treatment (weeks 12, 24 and 48) in sera. The factors associated with HBV DNA undetectable and HBsAg <100 IU/ml at treatment 48 weeks were assessed. : This study involved 45 patients. There was HBV DNA undetectable in 36 cases (80%), including 19 (52.8%) with HBsAg <100 IU/ml at week 48. The HBV DNA <2.0 logIU/ml at week 24 (PPV = 96.9%, NPV = 66.7%, = 0.018) was an independent predictor of HBV DNA undetectable at week 48. The HBsAg <800 IU/ml at baseline (PPV = 92.1%, NPV = 69.7%, = 0.054) and HBsAg decline >5.00-fold at week 24 (PPV = 83.3%, NPV = 77.8%, = 0.038) were independent predictors of HBsAg <100 IU/ml and HBV DNA undetectable at week 48. : Early on-treatment quantification of HBV DNA and HBsAg in patients with HBeAg-negative CHB treated with peg-IFN α-2a may help identify those likely to be cured by this method and optimize therapy strategies.
中国乙肝e抗原(HBeAg)阴性慢性乙型肝炎(CHB)患者的比例迅速增加。然而,这些患者对聚乙二醇干扰素(peg-IFN)治疗的反应较差,且抗病毒治疗策略不一致。本研究旨在探讨乙肝病毒(HBV)DNA和乙肝表面抗原(HBsAg)在预测接受peg-IFNα-2a的HBeAg阴性CHB患者治疗反应中的作用。:2014年至2018年期间,未接受过治疗的HBeAg阴性患者参与了这项前瞻性研究。在基线以及治疗期间(第12、24和48周)对血清中的HBV DNA和HBsAg进行定量。评估了与治疗48周时HBV DNA检测不到以及HBsAg<100 IU/ml相关的因素。:本研究纳入了45例患者。36例(80%)患者的HBV DNA检测不到,其中19例(52.8%)在第48周时HBsAg<100 IU/ml。第24周时HBV DNA<2.0 logIU/ml(阳性预测值=96.9%,阴性预测值=66.7%,P=0.018)是第48周时HBV DNA检测不到的独立预测指标。基线时HBsAg<800 IU/ml(阳性预测值=92.1%,阴性预测值=69.7%)以及第24周时HBsAg下降>5.00倍(阳性预测值=83.3%,阴性预测值=77.8%,P=0.038)是第48周时HBsAg<100 IU/ml以及HBV DNA检测不到的独立预测指标。:对接受peg-IFNα-2a治疗的HBeAg阴性CHB患者进行早期治疗期间的HBV DNA和HBsAg定量,可能有助于识别那些可能通过该方法治愈的患者,并优化治疗策略。