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甲状腺功能紊乱与接受α-干扰素治疗的慢性乙型肝炎患者乙型肝炎表面抗原丢失有关。

Thyroid dysfunction is associated with the loss of hepatitis B surface antigen in patients with chronic hepatitis B undergoing treatment with α-interferon.

机构信息

State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China.

出版信息

J Int Med Res. 2021 Jun;49(6):3000605211025139. doi: 10.1177/03000605211025139.

Abstract

OBJECTIVE

To investigate the influence of thyroid dysfunction on the antiviral efficacy of α-interferon in adult patients with chronic hepatitis B (CHB).

METHODS

We performed a retrospective study of 342 patients with CHB who underwent interferon treatment for >12 weeks. Patients with thyroid dysfunction before or during treatment were defined as the thyroid dysfunction group (n = 141) and those with normal thyroid function were defined as the normal thyroid function group (n = 201). The prevalences of hepatitis B virus (HBV) DNA undetectability, low hepatitis B surface antigen (HBsAg) titre (<250 IU/mL), HBsAg loss, and hepatitis B envelope antigen loss were compared.

RESULTS

During interferon treatment, 69 of 270 (25.6%) participants with normal thyroid function at baseline developed thyroid dysfunction, whereas 11 of 72 (15.3%) with thyroid dysfunction at baseline regained normal thyroid function. The thyroid dysfunction group had significantly higher prevalences of low HBsAg titre (29.8% . 18.9%) and HBV DNA undetectability (66.0% . 40.3%). Multivariate logistic regression analysis showed that thyroid dysfunction was associated with HBsAg loss (odds ratio 4.945, 95% confidence interval 1.325-18.462).

CONCLUSIONS

These results suggest that thyroid dysfunction is not an absolute contraindication, but is associated with HBsAg loss, in patients with CHB undergoing α-interferon treatment.

摘要

目的

探讨甲状腺功能障碍对成人慢性乙型肝炎(CHB)患者α干扰素抗病毒疗效的影响。

方法

我们对 342 例接受干扰素治疗>12 周的 CHB 患者进行了回顾性研究。治疗前或治疗期间存在甲状腺功能障碍的患者定义为甲状腺功能障碍组(n=141),甲状腺功能正常的患者定义为甲状腺功能正常组(n=201)。比较两组患者乙型肝炎病毒(HBV)DNA 不可检测、低乙型肝炎表面抗原(HBsAg)滴度(<250 IU/ml)、HBsAg 丢失和乙型肝炎包膜抗原丢失的发生率。

结果

在干扰素治疗期间,270 例基线甲状腺功能正常的患者中有 69 例(25.6%)发生甲状腺功能障碍,而 72 例基线甲状腺功能障碍的患者中有 11 例(15.3%)恢复正常甲状腺功能。甲状腺功能障碍组低 HBsAg 滴度(29.8%比 18.9%)和 HBV DNA 不可检测率(66.0%比 40.3%)明显更高。多变量逻辑回归分析显示,甲状腺功能障碍与 HBsAg 丢失相关(优势比 4.945,95%置信区间 1.325-18.462)。

结论

这些结果表明,甲状腺功能障碍不是 CHB 患者接受α干扰素治疗的绝对禁忌证,但与 HBsAg 丢失相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55ff/8246510/628e0293ea6c/10.1177_03000605211025139-fig1.jpg

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