AASLD2012:儿童聚乙二醇干扰素治疗的有效性和安全性

StephenW

儿童聚乙二醇干扰素治疗的有效性和安全性
慢性B型肝炎
*TITLE: *The efficacy and safety of Peginterferon treatment in children
with chronic hepatitis B

*AUTHORS (FIRST NAME, LAST NAME): *_Hua Y. Liu_^1 , Zhen Li^1 , Li Liu^1 , Dan Peng^1

*Institutional Author(s): *

*INSTITUTIONS (ALL): *1. The 3rd People's Hospital of Kunming, Kunming, China.

*ABSTRACT BODY: *Aim: To evaluate the efficacy and safety of Peginterferon a-2a antiviral treatment in children with chronic hepatitis B in a prospective study.
Method: 31 children aging from 2 to 16 years old were included in this study. All subjects were divided into two groups: 17 were in the younger- age group with mean age 3.7 yrs old and 14 in the elder-age group with mean age 12.8.
Peginterferon a-2a was administrated 4.5µg/kg weekly at first and adjusted to 135µg weekly 2-4 weeks later. Total treatment duration ranged from 52 weeks to 104 weeks. Liver function, blood routine, HBV seromarkers and HBV DNA level were measured and during the study.
Result: HBV DNA suppression rates(<1.000E+02 IU/ml) at 24 weeks were 64.7% and 57.1% in the younger-age group and elder-age group, respectively, and reached 100% at 72 weeks in both groups(P all>0.05).
HBsAg clearance rate, HBsAb positive rate, HBeAg clearance rate and HBeAb positive rate at 24 weeks were 41.2%, 35.3%, 41.2% and 47.1% in the younger-old group, which were higher than the elder-age group,with a significant difference at HBsAg positive rate between the two groups(P<0.05). The responses at 52 weeks were similar to 24 weeks, reflected as: HBsAg clearance rate 53.3% and 28.6%, HBsAb positive rate 53.3% and 21.4%, HBeAg clearance rate 60% and 42.9%, and HBeAb positive rate 60% and 35.7%. No significant difference was observed at 52 weeks (P>0.05).
In children underwent 72-week course, HBV DNA suppression rate, HBsAg seroconversion rate and HBeAg seroconversion rate were 100%, 60% and 80%, respectively. Furthermore, rapid HBsAg declines were observed at 24wks (HBsAg decline:0.85lg IU/ml vs 0.24lg IU/ml) and 52wks((HBsAg decline:2.97lg IU/ml vs 0.98lg IU/ml) in the younger-old group when compared with the elder age group.
Among 31 subjects, 25 were followed-up to at least 12 weeks after discontinuation of treatment and none relapsed. Besides, HBsAg and HBeAg seroconversion were observed in some patients post-treatment.
Flu-like symptom was a common side effect in treated children. Pre- and post-treatment height and weight were similar between the two groups.
Conclusion: Peginterferon a-2a therapy is an optimal treatment option for children with chronic hepatitis B. Extended course and younger age are associated with an improved treatment outcome. Rapid HBsAg declines at 24 wks and 52wks were observed in the younger-age group, suggesting HBsAg decline as an independent predictive factor for treatment outcome.

StephenW

*标题：*聚乙二醇干扰素治疗的有效性和安全性的儿童
慢性B型肝炎

*作者（名字，姓）：* _Hua Y. Liu_ ^ 1，甄励^ 1，李柳^ 1，丹鹏^ 1

*机构（作者）：*

*机构（ALL）：* 1。中国，昆明，昆明第三人民医院。

*抽象的身体：目的：评价疗效和安全性的聚乙二醇干扰素A-2A抗病毒治疗儿童慢性乙型肝炎的前瞻性研究。
方法：年龄在2岁到16岁的31名儿童被纳入了这项研究。所有的受试者被分成两组：年轻的，平均年龄3.7岁儿童中的老年人，平均年龄12.8岁年龄组和14岁年龄组17人。
聚乙二醇干扰素-2a中4.5μg/kg每周的第一个管理和调整至135μg每周2-4周后。总的治疗时间从52周104周不等。肝功能，血常规，HBV的seromarkers和HBV DNA水平进行了测量和研究过程​​中。
结果：HBV DNA抑制率（<1.000E +02 IU /毫升），24周时在年轻的年龄组和年长年龄组分别为64.7％和57.1％，分别达到100％，在72个星期，在这两个群体（ P均> 0.05）。
HBsAg清除率，HBsAb阳性率，在24周的HBeAg清除率和HBeAb阳性率分别为41.2％，35.3％，41.2％和47.1％，在年轻的年龄组，其中较年长的年龄组，具有显着在HBsAg阳性率之间的两组（P <0.05）的差异。在第52周〜24周的反应，体现为：HBsAg清除率53.3％和28.6％，HBsAb阳性率53.3％和21.4％，HBeAg清除率60％和42.9％，和HBeAb阳性率为60％，和35.7％ 。在52周时无显着性差异（P> 0.05）。
在儿童中进行了72周的课程，HBV DNA抑制率，乙肝表面抗原转阴率和HBeAg血清转换率分别为100％，60％和80％，分别为。此外，观察快速乙肝表面抗原下降，在24wks（HBsAg的下降：0.85lg IU / ml和0.24lg IU /毫升）和52周（（乙肝表面抗原下降：2.97lg的IU / ml和0.98lg IU /毫升），更年轻的年龄组相比老愤怒。
在31例中，有25人停药后没有复发的治疗和随访，以至少12周。此外，HBsAg和HBeAg血清转换率观察到一些患者治疗后。
类似流感的症状是常见的副作用，在治疗的儿童。前和治疗后的身高和体重，两组间相似。
结论：聚乙二醇干扰素-2a治疗慢性B型肝炎扩展课程和年龄的儿童是最佳的治疗选择与一个更好的治疗结果。在年轻的年龄组在24周和52周观察快速乙肝表面抗原下降，这表明乙肝表面抗原下降的独立预测因子治疗结果。

咬牙硬挺

好消息，不过现在母婴阻断和疫苗接种做的到位，新感染的幼儿很少很少了。