Li Minghui, Xie Si, Bi Xiaoyue, Sun Fangfang, Zeng Zhan, Deng Wen, Jiang Tingting, Lin Yanjie, Yang Liu, Lu Yao, Zhang Lu, Yi Wei, Xie Yao
Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
Department of Hepatology Division 2, Peking University Ditan Teaching Hospital, Beijing, China.
Front Microbiol. 2022 Aug 30;13:960589. doi: 10.3389/fmicb.2022.960589. eCollection 2022.
To investigate the effect of intermittent interferon therapy mode on the disappearance of hepatitis B surface antigen (HBsAg) in chronic hepatitis B (CHB) patients.
This is a retrospective cohort study in CHB patients who were suspended from pegylated interferon α (PEG-IFNα) therapy due to a plateau in HBsAg decline during the initial treatment period, and resumed interferon therapy after an interval of 3-6 months. Patients received entecavir or tenofovir during the interval period. Hepatitis B virus (HBV) virological and serological indexes, clinical biochemical indexes, and blood routine tests were performed at the baseline and every 3 months during follow-up of initial interferon treatment. A functional cure was analyzed as a primary outcome.
A total of 304 patients treated with intermittent PEG-IFNα were included in the statistical analysis, including 215 men and 89 women, aged 37.97 ± 8.53 years, and 73 hepatitis B e antigen (HBeAg)-negative and 231 HBeAg positive patients. In total 59 patients (19.41%) achieved HBsAg disappearance through the initial, intermittent, and retreatment of PEG-IFNα treatment, of whom 43 patients (14.14%) achieved HBsAg seroconversion. Early HBsAg response to initial treatment was significantly associated with HBsAg response at 12 and 24 weeks of retreatment. After the intermission period, the incidence of HBsAg disappearance in patients with early HBsAg response in the retreatment period was 43.87%. The baseline HBsAg and 12-week HBsAg response in the retreatment period had higher predictive value than the initial treatment HBsAg response.
The initial, intermittent, and retreatment mode of interferon can help to improve the HBsAg disappearance rate in CHB patients.
[www.ClinicalTrials.gov], identifier [NCT04028856].
探讨间歇干扰素治疗模式对慢性乙型肝炎（CHB）患者乙肝表面抗原（HBsAg）消失的影响。
这是一项回顾性队列研究，研究对象为在初始治疗期间因HBsAg下降停滞而暂停聚乙二醇干扰素α（PEG-IFNα）治疗，间隔3 - 6个月后恢复干扰素治疗的CHB患者。患者在间隔期接受恩替卡韦或替诺福韦治疗。在初始干扰素治疗随访期间，于基线及每3个月进行乙肝病毒（HBV）病毒学和血清学指标、临床生化指标及血常规检查。将功能性治愈作为主要结局进行分析。
共有304例接受间歇PEG-IFNα治疗的患者纳入统计分析，其中男性215例，女性89例，年龄37.97±8.53岁，乙肝e抗原（HBeAg）阴性患者73例，HBeAg阳性患者231例。通过初始、间歇及再次PEG-IFNα治疗，共有59例患者（19.41%）实现HBsAg消失，其中43例患者（14.14%）实现HBsAg血清学转换。初始治疗时早期HBsAg反应与再次治疗12周和24周时的HBsAg反应显著相关。间歇期后，再次治疗期早期HBsAg反应患者的HBsAg消失发生率为43.87%。再次治疗期的基线HBsAg及12周时的HBsAg反应比初始治疗时的HBsAg反应具有更高的预测价值。
干扰素的初始、间歇及再次治疗模式有助于提高CHB患者的HBsAg消失率。
