He Yi, Zhou Yingzhi, Wang Huimin, Peng Xiaorong, Chang Yunan, Hu Peng, Ren Hong, Xu Hongmei
Department of Infection, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders. Chongqing Key Laboratory of Child Infection and Immunity, Chongqing Medical University, 136, Zhongshan Road, Yuzhong District, Chongqing, 400014, People's Republic of China.
Department of Infectious Diseases, Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China.
BMC Pediatr. 2022 Jul 20;22(1):426. doi: 10.1186/s12887-022-03482-0.
Pegylated interferon alpha-2a (peg-IFN α-2a) and entecavir (ETV) are both recommended as the first-line antiviral drugs for chronic hepatitis B (CHB) at present. We aimed to compare the efficacy and safety between peg-IFN α-2a and ETV initial therapy in children and adolescents with CHB and investigate the potential factors affecting the treatment response during the first 48 weeks.
We retrospectively selected 70 treatment-naïve children and adolescents with CHB who received peg-IFN α-2a(n = 26) or ETV(n = 44) as initial therapy and completed 48-week follow-up for data analysis. Blood samples before treatment were collected from 26 patients of the cohort to assess the cytokine profiles.
We found that initial peg-IFN therapy results in higher rates of hepatitis B surface antigen (HBsAg) serological response (SR) but lower rates of virological and biochemical response rates compared to ETV at week 48. As for achieving hepatitis B e antigen (HBeAg) SR, peg-IFN was comparable to ETV in the univariate analysis and turned out to be better than ETV after adjustment for important baseline factors. We also found that elevated pre-treatment IL-18 level was significantly associated with HBeAg SR, and remained as the only independent factor of predicting HBeAg SR after adjustment for other important factors. No serious adverse effects of the 2 drugs were reported during the 48-week follow-up.
comparing to ETV, peg-IFN was superior in achieving HBsAg and HBeAg SR; higher baseline IL-18 levels were independently associated with HBeAg SR in this study of children and adolescents with CHB.
聚乙二醇化干扰素α-2a（peg-IFN α-2a）和恩替卡韦（ETV）目前均被推荐作为慢性乙型肝炎（CHB）的一线抗病毒药物。我们旨在比较peg-IFN α-2a和ETV初始治疗对CHB儿童和青少年的疗效与安全性，并调查在最初48周内影响治疗反应的潜在因素。
我们回顾性选择了70例初治的CHB儿童和青少年，他们接受了peg-IFN α-2a（n = 26）或ETV（n = 44）作为初始治疗，并完成了48周的随访以进行数据分析。从该队列的26例患者中收集治疗前的血样以评估细胞因子谱。
我们发现，与ETV相比，初始peg-IFN治疗在第48周时导致更高的乙肝表面抗原（HBsAg）血清学反应（SR）率，但病毒学和生化反应率较低。至于实现乙肝e抗原（HBeAg）SR，在单因素分析中peg-IFN与ETV相当，在对重要基线因素进行调整后，结果显示优于ETV。我们还发现，治疗前IL-18水平升高与HBeAg SR显著相关，并且在对其他重要因素进行调整后，仍然是预测HBeAg SR的唯一独立因素。在48周的随访期间，未报告这两种药物的严重不良反应。
与ETV相比，peg-IFN在实现HBsAg和HBeAg SR方面更具优势；在这项针对CHB儿童和青少年的研究中，较高的基线IL-18水平与HBeAg SR独立相关。
