干扰素α-2b与聚乙二醇化干扰素α-2a单药治疗慢性乙型肝炎

StephenW

World J Pediatr. 2019 Sep 5. doi: 10.1007/s12519-019-00303-w. [Epub ahead of print]
Efficacy and safety of interferon alpha-2b versus pegylated interferon alpha-2a monotherapy in children with chronic hepatitis B: a real-life cohort study from Shanghai, China.
Hu Y1, Ye YZ1, Ye LJ1, Wang XH1, Yu H2.
Author information

1
    Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, 201102, China.
2
    Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, 201102, China. [email protected].

Abstract
BACKGROUND:

Interferon alpha (IFN-α) is a preferred therapy for antiviral treatment of children with chronic hepatitis B (CHB) aged > 1 year currently. Peginterferon alpha-2a (Peg-IFN α-2a) is a recommended international guideline for treatment of CHB children, which is limited to children aged > 3 years. But the exact efficacy and safety of IFN-α and Peg-IFN α-2a for treating CHB are not sufficient.
METHODS:

Clinical manifestations, baseline characteristics, related laboratory tests and adverse events were retrospectively analyzed in children with CHB, who visited Children's Hospital of Fudan University and were treated with IFN α-2b or Peg-IFN α-2a monotherapy and followed up from January 2003 to October 2018.
RESULTS:

A total of 36 immune-active patients without advanced fibrosis were enrolled to be treated with IFN α-2b (group A, n = 18) or Peg-IFN α-2a (group B, n = 18). IFN α-2b or Peg-IFN α-2a was administered for a median of 48 weeks subcutaneously by body surface area (BSA) category at a dose of 3 MU/m2 or 104 μg/m2, respectively. HBV e antigen (HBeAg) seroconversion rates at 48 weeks post-treatment were higher in group A than group B (92.9% vs. 87.5%), so as the rates of HBsAg clearance (22.2% vs. 11.1%), and hepatitis B virus (HBV)-DNA < 1000 IU/mL (88.9% vs. 83.3%). Only mild flu-like symptoms and transient neutropenia appeared in some children at the early stage of treatment. No severe abnormal results was observed in other laboratory assessments.
CONCLUSION:

The antiviral monotherapy of 48-week IFN α-2b or Peg-IFN α-2a in children with CHB is well tolerated and effective, which is associated with higher rates of HBeAg seroconversion and HBsAg clearance than in adults and previously pediatric patients.
KEYWORDS:

Antiviral therapy; Children; Chronic hepatitis B; Interferon alpha; Pegylated interferon alpha

PMID:
    31487005
DOI:
    10.1007/s12519-019-00303-w

StephenW

World J Pediatr。 2019年9月5日：doi：10.1007 / s12519-019-00303-w。 [印刷前的电子版]
干扰素α-2b与聚乙二醇化干扰素α-2a单药治疗慢性乙型肝炎患者的疗效和安全性：来自中国上海的现实生活队列研究。
胡Y1，叶YZ1，叶立J1，王XH1，于H2。
作者信息

1
复旦大学附属儿童医院感染科，上海201102
2
复旦大学附属儿童医院感染科，上海201102 [email protected]。

抽象
背景：

干扰素α（IFN-α）是目前年龄> 1年的慢性乙型肝炎（CHB）儿童抗病毒治疗的优选疗法。聚乙二醇干扰素α-2a（Peg-IFNα-2a）是治疗CHB儿童的推荐国际指南，仅限于3岁以上的儿童。但IFN-α和Peg-IFNα-2a治疗CHB的确切疗效和安全性还不够。
方法：

回顾性分析CHB儿童的临床表现，基线特征，相关实验室检查和不良事件，他们访问了复旦大学附属儿童医院并接受了IFNα-2b或Peg-IFNα-2a单药治疗，并于2003年1月开始随访。 2018年10月。
结果：

招募总共36名没有晚期纤维化的免疫活性患者用IFNα-2b（组A，n = 18）或Peg-IFNα-2a（组B，n = 18）治疗。 IFNα-2b或Peg-IFNα-2a分别以3MU / m 2或104μg/ m 2的剂量通过体表面积（BSA）类别皮下施用中位48周。治疗后48周HBV e抗原（HBeAg）血清转换率A组高于B组（92.9％vs。87.5％），HBsAg清除率（22.2％vs。11.1％）和乙型肝炎病毒（HBV）-DNA <1000 IU / mL（88.9％对83.3％）。在治疗的早期阶段，一些儿童仅出现轻微的流感样症状和短暂的中性粒细胞减少症。在其他实验室评估中未观察到严重的异常结果。
结论：

在CHB患儿中，48周IFNα-2b或Peg-IFNα-2a的抗病毒单药治疗具有良好的耐受性和有效性，这与HBeAg血清转换和HBsAg清除率高于成人和既往儿科患者相关。
关键词：

抗病毒治疗;儿童;慢性乙型肝炎;干扰素α;聚乙二醇干扰素α

结论：
31487005
DOI：
10.1007 / s12519-019-00303-W

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