Long-term follow-up of hepatitis B e antigen-negative patients treated with pegi

StephenW

Eur J Gastroenterol Hepatol. 2012 Jun 3. [Epub ahead of print]
Long-term follow-up of hepatitis B e antigen-negative patients treated with peginterferon α-2a: progressive decrease in hepatitis B surface antigen in responders.
Rijckborst V, Ferenci P, Akdogan M, Pinarbasi B, Ter Borg MJ, Simon K, Flisiak R, Akarca US, Raptopoulou-Gigi M, Verhey E, van Vuuren AJ, Boucher CA, Hansen BE, Janssen HL; for the PARC Study Group.
Source
Departments of a Gastroenterology and Hepatology b Virology c Biostatistics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
d Department of Internal Medicine 3, Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
e Department of Gastroenterology, Turkiye Yuksek Ihtisas Hospital, Ankara
f Department of Gastroenterohepatology, Istanbul University Medical School, Istanbul
g Department of Gastroenterology, Ege University Faculty of Medicine, Izmir, Turkey
h Department and Clinic of Infectious Diseases, Hepatology and Acquired Immune Deficiencies, Medical University Wroclaw, Wroclaw
i Department of Infectious Diseases and Hepatology, Medical University of Bialystok, Bialystok, Poland
j Second Medical Department, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Abstract
OBJECTIVE: Peginterferon (PEG-IFN) is considered as a first-line treatment option for hepatitis B e antigen (HBeAg)-negative chronic hepatitis B. We aimed to evaluate the long-term response to PEG-IFN in HBeAg-negative patients.

METHODS: All patients enrolled in the PARC study who completed the treatment phase were eligible for this long-term follow-up (LTFU) study. Patients received PEG-IFN α-2a (180 μg weekly)±ribavirin (1000-1200 mg daily) for 48 weeks and had at least one additional LTFU visit after the initial follow-up period of 24 weeks (mean duration 2.1±0.2 years). Retreated patients were considered nonresponders.

RESULTS: Of 117 patients who completed the treatment phase, 79 (68%) were included in this LTFU study. Among 19 patients with a combined response at 24 weeks after treatment [initial responders; hepatitis B virus DNA<10 000 copies/ml (<1714 IU/ml) and normal alanine aminotransferase], 12 (63%) sustained this response through LTFU. Three additional patients showed such a response at LTFU, resulting in a total of 15 (19%) combined responders at LTFU. A marked decrease in the serum hepatitis B surface antigen (HBsAg) levels was observed in initial responders, resulting in HBsAg clearance in 26% of the patients (6% of all LTFU participants).

CONCLUSION: About one-third of HBeAg-negative patients with a response to PEG-IFN at 24 weeks after treatment subsequently had a relapse during 2 years of follow-up. Despite the limited overall efficacy of PEG-IFN, patients responding to PEG-IFN treatment showed a marked decrease in serum HBsAg, resulting in a high rate of HBsAg clearance, which indicates the need for predictors of response to PEG-IFN in HBeAg-negative disease.

StephenW

欧元胃肠肝胆病杂志。 2012年俊3。 [出处提前打印]
长期随访B型肝炎e抗原阴性的患者，用聚乙二醇干扰素α-2a的治疗：乙肝表面抗原反应逐步减少。至五rijckborst，Ferenci磷，中号Akdogan，Pinarbasi乙，TER博格兆焦耳，西蒙ķ，Flisiakŕ，Akarca美国，Raptopoulou梁咏琪中号，VerheyéVuuren欧塞尔，面包车，鲍彻的CA，汉森BE，扬森HL的帕洛阿尔托研究中心的研究集团。 SourceDepartments的aGastroenterology和肝病bVirology cBiostatistics，伊拉斯谟MC大学医学中心，鹿特丹，荷兰3内科，胃肠病学和肝病，医疗维也纳大学，维也纳，奥地利胃肠eDepartment的，TURKIYE Yuksek Ihtisas医院dDepartment，安卡拉Gastroenterohepatology fDepartment伊斯坦布尔大学医学院，伊斯坦布尔gDepartment消化科，EGE大学医学院，伊兹密尔，的土耳其hDepartment和诊所传染病，肝病和后天免疫缺陷，弗罗茨瓦夫医科大学，弗罗茨瓦夫传染病和肝病，比亚韦斯托克大学医学院iDepartment比亚韦斯托克，波兰jSecond医学部，萨洛尼卡亚里士多德大学，萨洛尼卡，希腊。


摘要

目的：聚乙二醇干扰素（PEG-干扰素）为B型肝炎e抗原（HBeAg）阴性慢性乙型肝炎的一线治疗方案，认为我们的目的是评估PEG-干扰素在HBeAg阴性患者的长期反应。

方法：所有患者在PARC的研究完成治疗阶段，这个长期的后续研究（LTFU）资格登记。患者接受聚乙二醇干扰素α-2a的（每周180微克）±利巴韦林48周（每天1000-1200毫克），初始的后续行动，为期24周（平均时间为2.1±0.2岁后至少有一个额外的LTFU访问）。复治患者均视为无效。

结果：117例患者完成治疗阶段，79（68％）被列入在此LTFU研究。其中19例患者治疗后24周的联合响应[最初的反应;乙型肝炎病毒DNA <10 000拷贝/毫升（<1714 IU /毫升）和正常谷丙转氨酶]，12（63％）持续通过LTFU这反应。三个额外的患者表现出在LTFU响应，在总共15个（19％）在LTFU结合反应。发现在最初的反应中血清乙型肝炎表面抗原（HBsAg）水平显着下降，造成26％的患者（6％）所有LTFU与会者在HBsAg清除。

结论：关于PEG-干扰素反应在24周的HBeAg阴性患者治疗后的三分之一，随后2年的随访期间复发。尽管有限的PEG-干扰素的整体效能，响应PEG-干扰素治​​疗的患者在血清HBsAg呈显着下降，导致在HBsAg清除，这表明需要PEG-干扰素在HBeAg阴性反应的预测率很高疾病。

咬牙硬挺

看不大明白，派罗欣治疗e抗原阴性效果到底好不好？两年内复发了30％?

把握当下

论文的意思是说e抗原阴性患者打干扰效果很好（治疗半年DNA<10 000 copies/ml (<1714 IU/ml) 并且alt正常）的这部分人（initial responders）大部分s抗原下降很多，以至于initial responders中26%s抗原转阴

initial responders应该还是极少部分
首先，initial responders一共19人，打完全程派罗欣的一共117人，加上没法完成派罗欣疗程的人在内，可能initial responders比例不足10%，并且initial responders或许本来就是好治疗的类型

StephenW

HBeAg阴性患者.
如果在24周时，你对干扰素治疗产生反应（HBVDNA<10,000拷贝/ ml，ALT正常），
你很可能在未来会维持这个反应，你也将有一个很好的机会会清除HBsAg。
因此，如果你能预测谁将会对治疗产生反应, 干扰素会是一个不错的选择.