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接受核苷酸类似物联合聚乙二醇干扰素治疗的HBeAg阴性慢性乙型肝炎患者HBsAg血清学清除的预测因素

Predictors of HBsAg seroclearance in HBeAg-negative chronic hepatitis B patients treated with nucleotide analogs plus polyethylene glycol interferon.

作者信息

Peng Yan, Ma Mingzhe, Liu Ting, He Wenmin, Lin Shutao, Zhong Wa, Min Xiaohui

机构信息

Department of Gastroenterology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.

Department of Infectious Disease, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.

出版信息

Front Med (Lausanne). 2025 Jan 8;11:1510230. doi: 10.3389/fmed.2024.1510230. eCollection 2024.

Abstract

INTRODUCTION

The minority of the chronic hepatitis B (CHB) patients received polyethylene glycol interferon (PEG-IFN) combined with nucleotide analogs (NAs) can obtain hepatitis B surface antigen (HBsAg) clearance.

METHODS

In order to find out the advantaged population, we retrospectively collected 122 CHB patients treated with NAs alone or NAs plus PEG-IFN for 48 weeks, who were admitted to Sun Yat-sen Memorial Hospital from 2019 to 2024.

RESULTS

We found HBsAg clearance rate in NAs plus PEG-IFN group was 40.98%, which was significantly higher than that in the NAs group. Thus, NAs plus PEG-IFN therapy served as a relatively ideal regimen and the patients received combined treatment were then incorporated for further analysis for searching efficacy predictors. Through using univariate and multivariate analysis, we confirmed the predictive value of HBsAg, alanine aminotransferase (ALT) at week 24, and ALT change values from baseline to week 24. The area under the receiver operating characteristic (ROC) curve of each indicators ranged from 0.663 to 0.982.

DISCUSSION

In conclusion, our study verified the clinical value of NAs plus PEG-IFN for treating CHB patients. Moreover, for the first time, we found ALT change values from baseline to week 24 (dALT2) could act as a novel independent clinical efficacy predictors in the forementioned population.

摘要

引言

少数慢性乙型肝炎(CHB)患者接受聚乙二醇干扰素(PEG-IFN)联合核苷酸类似物(NAs)治疗可实现乙肝表面抗原(HBsAg)清除。

方法

为找出优势人群,我们回顾性收集了2019年至2024年期间在中山大学孙逸仙纪念医院住院的122例仅接受NAs治疗或接受NAs联合PEG-IFN治疗48周的CHB患者。

结果

我们发现NAs联合PEG-IFN组的HBsAg清除率为40.98%,显著高于NAs组。因此,NAs联合PEG-IFN治疗是一种相对理想的方案,随后将接受联合治疗的患者纳入进一步分析以寻找疗效预测指标。通过单因素和多因素分析,我们证实了HBsAg、第24周时的丙氨酸氨基转移酶(ALT)以及从基线到第24周的ALT变化值的预测价值。各指标的受试者工作特征(ROC)曲线下面积在0.663至0.982之间。

讨论

总之,我们的研究验证了NAs联合PEG-IFN治疗CHB患者的临床价值。此外,我们首次发现从基线到第24周的ALT变化值(dALT2)可作为上述人群中一种新的独立临床疗效预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e9c/11751021/859505743c59/fmed-11-1510230-g001.jpg

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