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Safety and efficacy of two-step peginterferon α-2a treatment in patients of ch [复制链接]

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J Viral Hepat. 2012 Mar;19(3):161-72. doi: 10.1111/j.1365-2893.2011.01469.x. Epub  2011 Jul 4.
Safety and efficacy of two-step peginterferon α-2a treatment in patients of chronic hepatitis B with acute exacerbation.Chen CC, Wang PC, Chang HW, Chen CF.
Source
Division of Hepatology & Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Hsin-Chu, Taiwan.

Abstract
Summary.  The focus of this study was to evaluate the safety and efficacy of sequential peginterferon α-2a (Pegasys) therapy for chronic hepatitis B with acute exacerbation [ALT > 10 × upper limit of normal (ULN), bilirubin <2.0 mg/dL]. Four groups of patients categorized by HBeAg status and treatment regimens were studied since May 2007. Nineteen HBeAg-positive patients (Group 1) had received entecavir  pretreatment  (when ALT > 10 × ULN) plus Pegasys (180 μg/kg/week, when ALT was 5-10 × ULN) for 24 weeks. Thirteen HBeAg-negative patients (Group 2) had the same protocol for 48 weeks. In both groups, entecavir was then discontinued 14 days after the initiation of Pegasys. The results were compared, respectively, to 35 HBeAg-positive patients (Group 3) and 24 HBeAg-negative patients (Group 4), all with ALT > 5 × ULN, under continual entecavir monotherapy. The ALT levels of patients in Group 1 and 2 who had received entecavir pretreatment for a duration of 19.63 ± 3.34 days were below four times of ULN following 4 weeks of Pegasys treatment. At week 96, the rates of sustained virological response were 69.2% (9/13) and 80% (8/10), and the relapse rates were 23.1% (3/13) and 11.2% (1/9) for HBeAg-positive and HBeAg-negative patients with two-step Pegasys treatment, respectively. The HBeAg seroconversion rates were 46.2% in Group 1, and 42.1% in Group 3; HBsAg loss rates were 15.4% (2/13) in Group 1, and 30% (3/10) in Group 2, whereas none achieved HBsAg loss with entecavir monotherapy (Group 3 and 4). The two-step Pegasys treatment offers an alternative, other than the nucleos(t)ides, for treating chronic hepatitis B with acute exacerbation and provides a safe, efficacious, short-term and finite strategy.
© 2011 Blackwell Publishing Ltd.





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发表于 2012-2-28 07:37 |只看该作者
J病毒Hepat。 2012 03 19(3):161-72。 DOI:10.1111/j.1365-2893.2011.01469.x。 EPUB 2011年7月4。
两步聚乙二醇干扰素α-2a的治疗在急性发作的慢性乙型肝炎患者的安全性和有效性。
消委会陈,王电脑,硬件张,陈的CF。


司,新竹,台湾,马偕纪念医院内科肝病消化科。
抽象

摘要。本研究的重点是评估急性发作[ALT> 10×正常值上限(ULN)的,胆红素<2.0毫克/升的聚乙二醇干扰素α-2a的顺序(派罗欣)治疗慢性乙型肝炎的安全性和有效性。自2007年5月,四组分为HBeAg状态和治疗方案的患者进行了研究。十九HBeAg阳性患者(1)收到了恩替卡韦预处理(当ALT> 10×ULN),加上24周派罗欣(180微克/公斤/周,当ALT 5-10×ULN的)。十三HBeAg阴性患者(第2组)有48周相同的协议。在这两个群体中,恩替卡韦,然后停止派罗欣开始后的14天内。结果进行比较,分别以35 HBeAg阳性患者(第三组)和24 HBeAg阴性患者(第四组),与ALT> 5×ULN的,在不断的恩替卡韦单一。在第1组和2谁收到了恩替卡韦治疗前的19.63±3.34天的时间患者的ALT水平低于4倍ULN的PEGASYS治疗4周后。在96周,持续病毒学应答率分别为69.2%(9/13)和80%(8/10),复发率分别为23.1%(3/13)和11.2%(1/9)HBeAg阳性阳性和HBeAg阴性与两步派罗欣治疗的患者,分别。 HBeAg血清转换率在第1组,分别为46.2%和42.1%,第3组,HBsAg消失率分别为15.4%(2/13)在第1组,第2组和30%(3/10),而没有达到HBsAg消失恩替卡韦单药治疗(第3组和4)。两步派罗欣治疗提供了一种替代,用于治疗慢性乙型肝炎急性发作比其他核苷(酸)的IDE,并提供了一​​种安全,有效,短期和有限的战略。
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