延长干扰素α-2a治疗产生优越的病毒学应答

StephenW

http://www.ncbi.nlm.nih.gov/pubmed/23207332
Zhonghua Gan Zang Bing Za Zhi. 2012 Oct;20(10):737-41. doi: 10.3760/cma.j.issn.1007-3418.2012.10.006.
[Prolonged duration of the routine pegylated-interferon alfa-2a therapy produces superior virological response in HBeAg-positive chronic hepatitis B patients: a single-center cohort study].
延长常规聚乙二醇化干扰素α-2a治疗HBeAg阳性慢性乙型肝炎患者产生优越的病毒学应答:单中心队列研究
[Article in Chinese]
Zhu YY, Wu YL, Chen J, Zheng Q, Dong J, Jiang JJ.
Source

Liver Diseases Research Center, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian, China.
Abstract

Hepatitis B e antigen (HBeAg) seroconversion and/or hepatitis B surface antigen (HBsAg) clearance are considered as good prognostic indicators of treatment outcome in HBeAg-positive chronic hepatitis B (CHB) patients. While a sustained virological response (SVR) can be achieved by a finite 48-week course of pegylated-interferon alfa-2a (Peg-IFNalpha-2a), it has been suggested that longer-term treatment can improve the rate of SVR. Therefore, the aim of this study was to compare the effects of prolonged and routine Peg-IFNa-2a therapy in patients with HBeAg-positive CHB. Eighty-six consecutive patients diagnosed with HBeAg-positive CHB at our hospital between September 2006 and October 2009 were enrolled in the study. The patients were randomly assigned to receive Peg-IFNa-2a (180 mug once weekly) for either 48 weeks (routine therapy group, n = 53) or 72 weeks (prolonged therapy group, n = 33). Serum samples were collected from each patient every three months until the end of the 24-week follow-up, and standard viral and biochemical tests were carried out. Relapse was defined as HBV DNA concentrations more than 105 copies/mL or an HBeAg-positive test at the end of the 24-week follow-up. Chi-squared test and the t-test were used to determine the significance of intergroup differences. Logistic regression analysis was employed to determine the correlation of outcome parameters to treatment duration, expressed as odds ratio (OR) with 95% confidence interval (CI). The two treatment groups were similar at baseline (pre-treatment) in demographic data, sex ratio, age, alanine aminotransferase (ALT) level, HBV DNA load, and semi-quantitative level of HBeAg (s/co) (all, P more than 0.05). At the end of the 24-week follow-up, there were significant differences between the 48-week treatment group and the 72-week treatment group in patients with HBV DNA negativity (62.3% vs. 97.0%, x2 = 13.273, P = 0.000), HBeAg seroconversion (39.6% vs. 57.6%, x2 = 6.765, P = 0.009), HBsAg clearance (15.1% vs. 36.4%, x2 = 5.155, P = 0.023), and relapse (58.5% vs. 33.3%, x2 = 6.713, P = 0.010). Logistic regression analysis indicated that therapy duration was correlated to HBeAg clearance (OR = 3.702, 95% CI: 1.225 to 11.188) and male sex (OR = 3.005, 95% CI: 1.038 to 8.696) but not to HBeAg level at baseline (OR = 0.999, 95% CI: 0.998 to 1.000) or age (OR = 0.902, 95% CI: 0.839 to 0.970). In this single-center cohort study, superior therapeutic benefit was achieved by extending the Peg-IFNa-2a therapy out to 72 weeks for patients with HBeAg-positive CHB. The prolonged duration therapy produced a higher HBsAg loss ratio, HBeAg seroconversion ratio, HBV DNA negativity ratio, and a lower relapse ratio. Furthermore, HBeAg clearance was positively correlated with duration and male sex.

StephenW

中华肝脏病杂志。 2012年10月，20（10）:737-41。 DOI：10.3760/cma.j.issn.1007-3418.2012.10.006。
时间延长常规聚乙二醇化干扰素α-2a治疗HBeAg阳性慢性乙型肝炎患者的单中心队列研究]产生优越的病毒学应答。
[中国]
朱YY，YL吴，陈江，郑Q，董，江见鲸。
源

肝病研究中心，福建医科大学附属第一医院，福州350005，福建，中国。
抽象

B型肝炎e抗原（HBeAg）血清转换和/或B型肝炎表面抗原（HBsAg）的空隙，被认为是良好的预后指标HBeAg阳性慢性乙型肝炎（CHB）患者的治疗结果。虽然可以通过一个有限的48周的聚乙二醇化干扰素α-2a干扰素（PEG-干扰素α-2a）的持续病毒学应答（SVR），它已经表明，长期治疗可以提高SVR率。因此，本研究的目的是比较长期的和常规的PEG-IFNa的-2a治疗HBeAg阳性CHB患者的影响。在我们医院2006年9月至2009年10月连续88个诊断为HBeAg阳性CHB患者参加了这项研究。患者被随机分配接受PEG-IFNa的-2a干扰素（每周一次）180杯或者48周（常规治疗组，n = 53）或72周（长期治疗组，n = 33）。收集血清样品从每个病人每三个月，直到结束的24周的随访，以及病毒和生化标准进行测试。复发被定义为HBV DNA浓度超过105拷贝/毫升或24周的随访结束时的HBeAg阳性的测试。使用卡方检验和t-试验间的差异来确定的意义。 Logistic回归分析结果参数，以确定相关的治疗时间，比值比（OR）和95％可信区间（CI）表示。两个治疗组在基线（治疗前）的人口统计数据，性别比例，年龄，丙氨酸氨基转移酶（ALT）水平，HBV DNA载量，e抗原（S / CO）和半定量的水平（均P更多于0.05）。在结束24周的随访，治疗48周和72周治疗组患者HBV DNA转阴之间有显着性差异（62.3％比97.0％，X2 = 13.273，P = 0.000），HBeAg血清转换率（39.6％比57.6％，X2 = 6.765，P = 0.009），乙肝表面抗原清除率（15.1％比36.4％，X2 = 5.155，P = 0.023），复发率（58.5％比33.3％ ，X2 = 6.713，P = 0.010）。 Logistic回归分析结果表明，治疗持续时间呈正相关（OR = 3.702，95％CI：1.225至11.188）和男性（OR = 3.005，95％CI：1.038到8.696），但在基线HBeAg水平（OR HBeAg清除= 0.999，95％CI：0.998〜1.000）和年龄（OR = 0.902，95％CI：0.839〜0.970）。在单中心的队列研究，优越的治疗效果，达到延长PEG-IFNa的-2a治疗72周，HBeAg阳性CHB患者。时间的延长治疗产生了较高的HBsAg消失率，HBeAg血清转换率，HBV DNA转阴率，并降低复发率。此外，HBeAg清除呈正相关，持续时间和男性。

咬牙硬挺

表面抗原转化率太高了吧，怀疑