[中华肝脏病杂志]聚乙二醇干扰素α-2a治疗HBV DNA和HBsAg应答良

StephenW

而对聚乙二醇干扰素α-2a治疗HBV DNA和HBsAg应答良好的慢性乙型肝炎患者，延长疗程可提高HBsAg消失/血清学转换率（李明慧等，第182～185页）
Zhonghua Gan Zang Bing Za Zhi. 2011 Mar;19(3):182-5. doi: 10.3760/cma.j.issn.1007-3418.2011.03.008.
[High rates of HBsAg loss and seroconversion result from prolonged course of pegasys treatment]. [Article in Chinese]
Li MH, Xie Y, Lu Y, Qiu GH, Liu F, Li XH, Zhao H, Song SJ, Guan XP, Cheng J, Xu DZ.
SourceLiver Diseases Center, Beijing Ditan Hospital, Capital Medical University, Beijing, China.

AbstractOBJECTIVE: HBsAg loss and seroconversion in patients with chronic hepatitis B leads to long-lasting good clinical outcomes. The aim of this paper was to investigate to improve the rate of HBsAg loss and seroconversion in chronic hepatitis B patients by prolonged treatment of PEG-IFNa-2a. 217 cases of HBeAg-positive or negative patients were collected from inpatient and outpatient in Beijing Ditan Hospital from May 2005 to October 2009 and subcutaeous injection of 135 ug or 180 ug PEGASYS were given once a week according to body weights. The drug doses were adjusted according to the neutrophilic granulocyte and platelet counts during treament course. Quantitative HBV DNA test was conducted using a commercially available real-time fluorescence quantitative PCR kit. The serum HBsAg/anti-HBs and HBeAg/anti-HBe were quantitatively detected by Abbott i 2000 chemiluminescent kit before and during treatment every three months. Patients with HBsAg steadily decreased and reached serum HBsAg level below 200 IU/ml after 48 weeks of treatment would receive prolonged treatment. Patients with more than 12 weeks of treatment entered into analysis. Main efficacy of prolonged treatment was evaluated by the incidences of HBsAg loss and seroconversion.
RESULTS: The treatment courses of the 217 patients ranged from 12.0 to 197.6 weeks with an average of 53.1+/-33.4 weeks, 118 cases took more than 48 weeks and another 89 cases less than 48 weeks. 13.4% (29/217) of patients achieved HBsAg loss or HBsAg seroconversion with treatment courses from 17.6 to 197.6 weeks (average 75.4+/-42.8 weeks). Among these 29 patients 24 (82.8%) received more than 48 weeks of treatment, but the treatment courses of HBV DNA reached undetectable level were 20.8+/-8.9 weeks. In this study, 9.5% (14/148) of HBeAg-positive patients achieved HBsAg loss or seroconversion, all of them treated more than 48 weeks, from 48 to 194 weeks, average 81.32+/-39.36 weeks. 21.7% (15/69) of HBeAg-negative patients achieved HBsAg loss or seroconversion, significantly higher than that of HBeAg-positive patients (9.5%) (x2 = 6.129, P = 0.013). The average treatment course for HBeAg-negative patients with HBsAg loss was 70.2+/-48.0 weeks, shorter than that of HBeAg-positive patients with HBsAg loss (81.3+/-39.4 weeks), but no significant difference (t = -0.522, P = 0.602) found between.
CONCLUSION: Higher rate of HBsAg loss and seroconversion could be obtained by individual extended treatment courses in patients with rapid HBV DNA and HBsAg response to PEG-IFNa-2a treatment and the HBeAg-negative patients could got higher rate of HBsAg loss than HBeAg-positive patients.

PMID:21586235 [PubMed - in process]



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StephenW

摘要
目的：

HBsAg转阴，并与慢性乙型肝炎患者血清转换导致长期良好的临床效果。本文的目的是探讨改善HBsAg消失和慢性乙型肝炎患者血清转换通过的PEG - IFNa的- 2a的长期治疗率。 217 e抗原阳性或阴性的患者例均采自2005年5月的住院和门诊在北京地坛医院2009年10月和135微克或180微克派罗欣subcutaeous注射了一个星期服用一次按体重。这种药物剂量调整根据中性粒细胞和血小板计数在treament课程。乙肝病毒DNA的定量检测是利用市售的实时荧光定量PCR试剂盒。血清乙肝表面抗原/抗- HBs和HBeAg /抗- HBe的雅培我进行了定量化学发光试剂盒检测2000年前和治疗期间每三个月。与HBsAg患者稳步下降，达到低于200国际单位血清HBsAg水平/毫升治疗48周后会得到长期治疗。有超过12周的治疗，患者进入分析。长期治疗的主要疗效评价损失和乙肝表面抗原血清转换的发生率。
结果：

在217位病人的治疗课程，从12.0一百九十七点六个星期与不等，平均为53.1 + / -33.4周，118例发生超过48周，另89例不超过48周。 13.4％（217分之29）的患者达到HBsAg转阴或HBsAg血清转换与疗程从17.6一百九十七点六个星期（平均75.4 + / -42.8周）。其中29例24（82.8％）接受治疗超过48周，但乙肝病毒DNA的疗程达不到水平分别为20.8 + / -8.9周。在这项研究中，9.5％（148分之14）e抗原阳性的患者达到表面抗原转阴或血清转化，他们全部被从48至194周，平均81.32 + / -39.36周超过48周。 21.7％的HBeAg阴性患者（69分之15）达到乙肝表面抗原转阴或血清转化，显着高于HBeAg阳性患者（9.5％）高（χ2= 6.129，P值0.013）。对于HBeAg阴性患者的平均治疗乙肝表面抗原的损失当然是70.2 + / -48.0周，较与HBsAg损失（81.3 + / -39.4周）e抗原阳性的患者要短，但无显着差异（t = -0.522， P值0.602），发现两者之间。
结论：

较高的乙肝表面抗原转阴率和损失可以得到个别患者延长疗程乙肝病毒DNA的快速反应和HBsAg的PEG - IFNa的- 2a治疗和HBeAg阴性的患者可以得到较高的乙肝表面抗原比e抗原阳性患者的损失率。

我随心动

回复 StephenW 的帖子

有没有在澳大利亚悉尼的战友或者专家阿!求助!!!!
有空请帮忙给看看，谢谢。

StephenW

回复 我随心动 的帖子

当然，我会尽我所能.

GodBless丹

StephenW, 你好啊，HI，本人现在在悉尼，我老婆大三阳，即将来澳洲与我团聚，我想知道一下在澳洲哪里可以做乙肝的定期检查，还有据说替诺的药效很好，这个在澳洲贵吗，本人是PR，有MEDICARE，老婆也应该会有，可以报销吗，还是要买私人保险？
.

StephenW

回复 GodBless丹 的帖子

在澳洲哪里可以做乙肝的定期检查 - any GP, they will refer you to a specialist.
还有据说替诺的药效很好，这个在澳洲贵吗 - it is covered by Medicare.
本人是PR，有MEDICARE，老婆也应该会有 - I don't know, I think she should be.
可以报销吗 - I think  medications over $1000 per year are then free.
还是要买私人保险？Private insurance only covers stay in a private hospital. Public hospitals are free, so no need.

GodBless丹

GOOD ANSWER!!! SO HELPFULL!!!