[英语研究] Peginterferon alpha-based therapy for chronic hepatitis B focusi

StephenW

http://7thspace.com/headlines/385498/peginterferon_alpha_based_therapy_for_chronic_hepatitis_b_focusing_on_hbsag_clearance_or_seroconversion_a_meta_analysis_of_controlled_clinical_trials.html

Peginterferon alpha-based therapy for chronic hepatitis B focusing on HBsAg clearance or seroconversion: a meta-analysis of controlled clinical trials

Interferon alpha (IFNalpha) therapy has been widely used in the treatment of chronic hepatitis B (CHB) for decades. Nucleos(t)ide analogues are also increasingly used to treat CHB recently.

More and more studies are being carried out concerning the clearance or seroconversion of HBsAg, which is recognized as an ideal goal of CHB therapy. This study conducted a meta-analysis to estimate the effect of pegylated interferon alpha (peginterferon alpha, PEG-IFNalpha)-based therapy on HBsAg clearance or seroconversion in CHB.

Methods: All available controlled clinical trials, published from 2004 to 2010, with the following antiviral therapies for CHB patients: PEG-IFNalpha combined with lamivudine (LAM), PEG-IFNalpha only, conventional IFNalpha and LAM, with a course [greater than or equal to]24 weeks, were meta-analysed for HBsAg clearance and seroconversion.

Results: Fourteen trials (involving a total of 2,682 patients) were identified, including seven high-quality and seven low-quality studies.

The analysis results of the different antiviral therapies on HBsAg clearance or seroconversion were as follows:

1. No significant difference in HBsAg clearance or seroconversion was observed between the combination therapy group and PEG-IFNalpha monotherapy group [odds ratio (OR) = 1.16, 95% confidence intervals (CI) (0.73-1.85), P = 0.54 and OR = 1.07, 95% CI (0.58-1.97), P = 0.82, respectively];

2.HBsAg clearance and seroconversion rates in patients with combination therapy were markedly higher than in those with LAM monotherapy [OR = 9.41, 95% CI (1.18-74.94), P = 0.03, and OR = 12.37, 95% CI (1.60-95.44), P = 0.02, respectively];

3. There was significant difference in HBsAg clearance between the PEG-IFNalpha group and IFNalpha monotherapy group [OR = 4.95, 95% CI (1.23-20.00), P = 0.02], but not in seroconversion [OR = 2.44, 95% CI (0.35-17.08), P = 0.37];

4. PEG-IFNalpha was superior to LAM in HBsAg seroconversion [OR = 14.59, 95% CI (1.91-111.49), P = 0.01].

Conclusions: PEG-IFNalpha facilitated HBsAg clearance or seroconversion in CHB patients. PEG-IFNalpha-based therapy was more effective than LAM monotherapy in achieving HBsAg clearance or seroconversion for both HBeAg-positive and HBeAg-negative CHB patients.

There was no significant difference in HBsAg clearance or seroconversion between PEG-IFNalpha/LAM combination therapy and PEG-IFNalpha monotherapy. PEG-IFNalpha was obviously superior to conventional IFNalpha in HBsAg clearance, but not in HBsAg seroconversion.

Although PEG-IFNalpha produced significantly higher rates of HBsAg clearance and seroconversion, the absolute change in the proportion ofHBsAg clearance and seroconversion was low (about 3-6%). Therefore, additional interventions are needed to improve the rate of positive outcomes.

Author: Wen-cong LiMao-rong WangLing-bo KongWei-guang RenYu-guo ZhangYue-min Nan
Credits/Source: BMC Infectious Diseases 2011, 11:165

StephenW

干扰素α（干扰素α）治疗已被广泛用于治疗慢性乙型肝炎（CHB）几十年来治疗。核苷（酸）类似物的IDE也越来越多地用于治疗慢性乙型肝炎最近。

越来越多的研究正在开展关于清除或乙肝表面抗原，这是作为一个公认的慢性乙型肝炎治疗的理想目标转阴。这项研究进行了荟萃分析，估计聚乙二醇干扰素α（聚乙二醇干扰素α，聚乙二醇干扰素α）为基础对HBsAg清除或血清中的乙肝治疗效果。

方法：将所有可用的对照临床试验，公布2004至10年，随着对慢性乙型肝炎患者抗病毒治疗后：聚乙二醇干扰素α与拉米夫定（林），聚乙二醇干扰素α只，常规干扰素α和LAM与课程相结合，[大于或等于] 24周，经统合为乙肝表面抗原转阴清理和分析。

结果：14项试验（涉及2682名病人）被确定，其中包括7个高品质，七个低质量的研究。

不同抗病毒疗法对HBsAg清除或血清分析结果如下：
1。无HBsAg清除或血清转化显着差异之间的联合治疗组和聚乙二醇干扰素α单药组[比值比（OR）= 1.16，95％可信区间（CI）（0.73-1.85），P值0.54和OR = 1.07 ，95％CI为（0.58-1.97），P值0.82，分别];

2.HBsAg清除及联合治疗患者的血清转换率明显高于单药治疗与林[或那些高= 9.41，95％CI为（1.18-74.94），P值0.03和OR = 12.37，95％CI为（1.60 - 95.44），P值0.02];

3。在有乙肝表面抗原之间的聚乙二醇干扰素α干扰素α单独治疗组和清理组显着性差异[或= 4.95，95％CI为（1.23-20.00），P值0.02]，但不是在转阴[或= 2.44，95％CI为（0.35 -17.08），P值0.37];

4。
聚乙二醇干扰素α优于乙肝表面抗原转阴林在[或= 14.59，95％CI为（1.91-111.49），P值0.01]。

结论：聚乙二醇干扰素α促进慢性乙型肝炎患者HBsAg清除或血清转化。聚乙二醇干扰素α-基础的治疗比单一治疗有效的实现林为HBeAg阳性和HBeAg阴性慢性乙型肝炎患者HBsAg清除或血清转化。

有没有乙肝表面抗原检查或联合用药之间PEG-IFNalpha/LAM和PEG -干扰素α单药血清显着差异。聚乙二醇干扰素α明显优于常规干扰素α在HBsAg清除，但在乙肝表面抗原转阴没有。

虽然聚乙二醇干扰素α产生了乙肝表面抗原转阴清除，在清理和血清转换比例ofHBsAg绝对变化率明显高于低（约3-6％）。因此，需要更多的干预措施，以提高阳性率的结果。

作者：文聪LiMao荣WangLing博KongWei光仁钰，郭ZhangYue敏楠
学分/资料来源：2011年的BMC传染病，11:165