Department of Infectious Diseases, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China (mainland).
Clinical Research Management Office, Third Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China (mainland).
Med Sci Monit. 2022 Mar 30;28:e934785. doi: 10.12659/MSM.934785.
BACKGROUND This single center study, which enrolled 108 patients with chronic hepatitis B virus infection treated with pegylated interferon-alpha (PEG-IFN-alpha), aimed to follow up and monitor off-treatment responses, including virological relapse, and analyze predictors of long-term efficacy of the PEG-IFN-alpha regimen. MATERIAL AND METHODS In total, 108 hepatitis B e antigen (HBeAg)-positive patients with chronic hepatitis B who had completed the PEG-IFN-alpha regimen and achieved virological suppression were enrolled. The patients were followed up for 5 years to monitor off-treatment responses. Twenty-eight relevant factors, including the history of antiviral therapy and HBeAg seroconversion, were analyzed using the Cox proportional hazards regression model. RESULTS The cumulative rates of virological suppression were 75.70%, 68.68%, 65.25%, 63.91%, and 63.91% at 1, 2, 3, 4, and 5 years of the follow-up period, respectively. Compared with the rates of virological suppression, the cumulative rates of clinical suppression were 88.41%, 79.83%, 78.59%, 75.65%, and 75.65%, respectively, for the 5 years. Alanine aminotransferase (ALT) normalization at 24 weeks after off-therapy (relative risk [RR]=3.430, P=0.013) was a potential predictor for sustained virological suppression, and the history of anti-viral therapy (RR=0.164, P=0.004), quantitative value of hepatitis B virus surface antigen (HBsAg) at 48 weeks of anti-viral therapy (RR=2.697, P=0.039), and ALT normalization at 24 weeks after off-therapy (RR=5.467, P=0.004) were potential predictors for sustained clinical suppression. CONCLUSIONS Our results suggested that increased HBsAg levels at 48 weeks and normalization of ALT at 24 weeks after off-therapy might be predictive factors for long-term treatment efficacy.[color=red] [/color].
本单中心研究纳入了 108 例接受聚乙二醇干扰素-α(PEG-IFN-α)治疗的慢性乙型肝炎病毒感染患者,旨在随访和监测停药后应答,包括病毒学复发,并分析 PEG-IFN-α方案长期疗效的预测因素。
共纳入 108 例乙型肝炎 e 抗原(HBeAg)阳性、完成 PEG-IFN-α治疗并实现病毒学抑制的慢性乙型肝炎患者,随访 5 年监测停药后应答。采用 Cox 比例风险回归模型分析 28 个相关因素,包括抗病毒治疗史和 HBeAg 血清学转换。
随访 1、2、3、4 和 5 年时,病毒学抑制的累积率分别为 75.70%、68.68%、65.25%、63.91%和 63.91%。与病毒学抑制率相比,5 年时临床抑制的累积率分别为 88.41%、79.83%、78.59%、75.65%和 75.65%。停药后 24 周时丙氨酸氨基转移酶(ALT)正常化(相对危险度 [RR]=3.430,P=0.013)是持续病毒学抑制的潜在预测因素,抗病毒治疗史(RR=0.164,P=0.004)、抗病毒治疗 48 周时乙型肝炎表面抗原(HBsAg)定量值(RR=2.697,P=0.039)和停药后 24 周时 ALT 正常化(RR=5.467,P=0.004)是持续临床抑制的潜在预测因素。
我们的结果表明,HBsAg 水平在 48 周时升高和停药后 24 周时 ALT 正常化可能是长期治疗疗效的预测因素。