核苷（酸）类似物和聚乙二醇干扰素α治疗慢性乙型肝炎患者临床结局的预测：一项血液生化和临床分析。
Predicting clinical outcomes in chronic hepatitis B patients receiving nucleoside analogues and pegylated interferon alpha: a hematochemical and clinical analysis.
机构信息
Department of infectious Diseases, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Department of infectious Diseases, The Second Affiliated Hospital and Yuying Children's Hospital, of Wenzhou Medical University, Wenzhou, China.
出版信息
BMC Infect Dis. 2024 Oct 13;24(1):1149. doi: 10.1186/s12879-024-10057-0.
BACKGROUND
The best antiviral treatment for chronic hepatitis B (CHB) poses a complex challenge. The treatment effect of the combination of nucleoside analogues (NAs) and pegylated interferon alpha (PegIFN) was still in debate.
METHODS
We studied patients treated with NAs and PegIFN-2b at our institution from November 2019 to January 2022. Logistic regression identified independent factors influencing clinical cure. The predictive accuracy of the formula was assessed using the Receiver operating characteristic (ROC) curve at different time points (before therapy, 12 weeks, and 24 weeks into treatment).
RESULTS
A total of 120 patients were enrolled in the final analysis. Among the cohort of patients under study, 71 (59.1%) patients had clinical cure while 49 (40.9%) patients did not. Hepatitis B surface antigen (HBsAg) at baseline and age were the powerful variables predicting the clearance of HBsAg. The area under the ROC (AUC) was 0.907 for pre-treatment predictive model, 0.958 for 12-week predictive model and 0.747 for 24-week predictive model.
CONCLUSION
This study provided predictive formulas for clinical cure, offering valuable insights for CHB treatment. PegIFN and NAs exhibited efficacy. Future research that explores additional factors, such as HBV genotype, in a larger cohort study is needed.
背景
慢性乙型肝炎（CHB）的最佳抗病毒治疗是一个复杂的挑战。核苷（酸）类似物（NAs）联合聚乙二醇干扰素α（PegIFN）的治疗效果仍存在争议。
方法
我们研究了 2019 年 11 月至 2022 年 1 月在我院接受 NAs 和 PegIFN-2b 治疗的患者。逻辑回归确定了影响临床治愈的独立因素。通过在不同时间点（治疗前、治疗 12 周和 24 周）使用接收者操作特征（ROC）曲线评估公式的预测准确性。
结果
共纳入 120 例患者进行最终分析。在研究队列中，71 例（59.1%）患者获得临床治愈，49 例（40.9%）患者未获得临床治愈。基线时乙型肝炎表面抗原（HBsAg）和年龄是预测 HBsAg清除的有力变量。治疗前预测模型的 ROC 曲线下面积（AUC）为 0.907，治疗 12 周预测模型的 AUC 为 0.958，治疗 24 周预测模型的 AUC 为 0.747。
结论
本研究提供了临床治愈的预测公式，为 CHB 治疗提供了有价值的见解。PegIFN 和 NAs 均显示出疗效。需要在更大的队列研究中探讨其他因素（如 HBV 基因型）以进一步研究。
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