Durable hepatitis B surface antigen decline in hepatitis B e antigen-positive ch

StephenW

Antivir Ther. 2012;17(1):9-17.
Durable hepatitis B surface antigen decline in hepatitis B e antigen-positive chronic hepatitis B patients treated with pegylated interferon-α2b: relation to response and HBV genotype.Sonneveld MJ, Rijckborst V, Cakaloglu Y, Simon K, Heathcote EJ, Tabak F, Mach T, Boucher CA, Hansen BE, Zeuzem S, Janssen HL.
SourceDepartment of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands.

AbstractBACKGROUND: On-treatment decline of serum hepatitis B surface antigen (HBsAg) may reflect the immunomodulatory effect of pegylated interferon (PEG-IFN) for hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB). We compared HBsAg decline across HBV genotypes between combined responders (HBeAg loss and HBV DNA<10,000 copies/ml at week 78), HBeAg responders (HBeAg loss with HBV DNA>10,000 copies/ml) and non-responders.
METHODS: HBsAg was measured at baseline, on-treatment and 6 months post-treatment in 221 HBeAg-positive CHB patients treated with PEG-IFN with or without lamivudine for 52 weeks, and in a representative subgroup of 142 patients at long-term follow-up (LTFU; mean 3.0 years).
RESULTS: On-treatment HBsAg decline significantly varied according to HBV genotype (A and B more than C and D; P<0.001). On-treatment HBsAg decline also differed between patients with a combined response (n=43) and those without (n=178; 3.34 versus 0.69 log IU/ml decline at week 52; P<0.001). Among patients without a combined response, no difference was observed between HBeAg responders (n=41) versus non-responders (n=137). HBsAg decline was sustained in combined responders and progressed to 3.75 log IU/ml at LTFU. Patients with a combined response achieved pronounced HBsAg declines, irrespective of HBV genotype, and those who achieved HBsAg levels <1,000 IU/ml at week 78 had a high probability of a sustained response and HBsAg clearance through LTFU.
CONCLUSIONS: On-treatment HBsAg decline during PEG-IFN therapy for HBeAg-positive CHB depends upon HBV genotype. Patients with a combined response to PEG-IFN achieve a pronounced HBsAg decline, irrespective of HBV genotype, which is sustained through 3 years of off-treatment follow-up.





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StephenW

Antivir  Ther.。 2012年，17（1）:9 - 17。
耐用乙肝表面抗原下降乙肝e抗原阳性慢性乙型肝炎患者治疗与聚乙二醇干扰素α2b：反应和HBV基因型的关系。
Sonneveld兆焦耳，Rijckborst V，Cakaloglu西蒙K，希思科特EJ，塔巴克F，T马赫，鲍彻的CA，汉森，Zeuzem S，扬森红莲。
来源

胃肠病学和肝病学杂志，伊拉斯谟的MC大学医学中心，鹿特丹，荷兰部。
摘要
背景：

治疗血清乙型肝炎表面抗原（HBsAg）的下降可能反映了聚乙二醇干扰素的免疫调节作用（PEG - IFN），乙型肝炎e抗原（HBeAg）阳性的慢性乙型肝炎（CHB）。我们比较了乙肝表面抗原结合应答（HBeAg转阴和HBV DNA <10,000拷贝/ ml，第78周），HBeAg的应答（HBeAg的损失与HBV DNA> 10000拷贝/毫升）和无应答之间的跨HBV基因型下降。
方法：

乙肝表面抗原是在基线，治疗6个月，有或没有拉米夫定52周PEG -干扰素治​​疗221例HBeAg阳性CHB患者的治疗后，在142例的代表分组长期跟进（LTFU;平均3.0年）。
结果：

在治疗乙肝表面抗原下降显著变化，根据HBV基因型（A和B超过C和D，P <0.001）。治疗乙肝表面抗原下降也有不同患者之间的联合反应（N = 43），没有那些（N = 178; 3.34与0.69日志IU / ml的52周下降，P <0.001）。没有结合反应的患者中，没有观察HBeAg的应答者（N = 41）与非应答者（N = 137）之间的差异。联合应答和HBsAg的下降是持续发展到3.75日志IU / LTFU毫升。与结合反应的患者达到HBsAg的下降明显，无论HBV基因型，以及那些取得HBsAg水平<1000 IU /周第78毫升的持续反应的概率高和HBsAg间隙通过LTFU。
结论：

治疗期间PEG -干扰素治​​疗HBeAg阳性慢性乙型肝炎表面抗原的下降取决于HBV基因型。 PEG -干扰素联合响应的患者达到了明显的HBsAg的下降，无论HBV基因型，这是通过3年的治疗后续持续。