Peginterferon and Entecavir Combination Therapy Improves Outcome of Non-Early Response Hepatitis B e Antigen-Positive Patients
Lu Chen 1 , Lanyi Lin 1 , Huijuan Zhou 1 , Weiliang Tang 1 , Hui Wang 1 , Wei Cai 1 , Shisan Bao 2 , Simin Guo 1 , Qing Xie 1
Affiliations
Affiliations
1
Department of Infectious Disease, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
2
Discipline of Pathology, School of Medical Science, Charles Perkins Centre, The Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
Background: The efficacy of nucleot(s)ide analogs (NAs) and pegylated interferon (PegIFN) combination therapy for hepatitis B e antigen-positive (HBeAg+) patients is still controversial. Whether PegIFN and entecavir (ETV) combination therapy could provide a greater benefit for HBeAg+ patients was assessed.
Methods: Treatment-naïve HBeAg+ patients initiated on PegIFN alfa-2a (PegIFNα-2a) for 24 weeks without early response (early response: HBsAg <1500 IU/mL and hepatitis B virus [HBV] DNA <105 copies/mL) were recruited in the current study. Among total of 94 patients, 51 were continued on PegIFNα-2a monotherapy, and 43 were offered PegIFNα-2a and ETV combined therapy.
Results: Better outcomes in response to the combined therapy, compared with that of the monotherapy, were demonstrated, including more HBsAg decline and loss and HBV DNA decline and HBeAg clearance. Importantly, the patients with HBsAg levels between 1500 and 20 000 IU/mL initially or between 5000 and 20 000 IU/mL after 24 weeks of PegIFNα-2a benefitted more from the combined therapy, compared with those on monotherapy.
Conclusions: Combined therapy of PegIFNα-2a and ETV is more efficacious for HBeAg+ patients without early response to PegIFN monotherapy, and HBsAg levels are a good predictor of treatment outcomes.
方法:招募未经PegIFN alfa-2a(PegIFNα-2a)治疗的初治HBeAg +患者,持续24周,且无早期反应(早期反应:HBsAg <1500 IU / mL,乙型肝炎病毒[HBV] DNA <105拷贝/ mL)在当前的研究中。在94例患者中,有51例继续接受PegIFNα-2a单药治疗,有43例接受了PegIFNα-2a和ETV联合治疗。
结果:与单一疗法相比,联合疗法的疗效更好,包括更多的HBsAg下降和丢失,HBV DNA下降和HBeAg清除。重要的是,与单药治疗相比,PegIFNα-2a最初的HBsAg水平在1500至20000 IU / mL或在24周后在5000至20000 IU / mL之间的患者从联合治疗中获益更多。