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本帖最后由 StephenW 于 2013-1-6 23:04 编辑
回复 yg88 的帖子
在国际的HBV论坛,MEDHELP (http://www.medhelp.org/forums/Hepatitis-B/show/223),有一个意大利的病人和朋友,stef2011,他与意大利的研究人员有很好的联系,他们劝告他,这是最好的策略.
Presentation Details
CONTROL ID: 1420280
PRESENTATION TYPE: Oral or Poster
CURRENT CATEGORY: Hepatitis B
CURRENT DESCRIPTORS: I03. Virology and Diagnostics
TITLE: Add-on of peg interferon to a stable nucleoside regimen led to loss of HBs Ag in chronic hepatitis HBeAg negative patients
AUTHORS (FIRST NAME, LAST NAME): Denis Ouzan1, Guillaume Penaranda2, Hélène Joly1, Hacène Khiri2, Philippe Halfon2
Institutional Author(s):
INSTITUTIONS (ALL): 1. Institut Arnault Tzanck, St-Laurent du Var, France.
2. Laboratoire ALPHABIO, Marseille, France.
ABSTRACT BODY: Suppression of HBV viral load by nucleoside treatment reduces disease progression but requires indefinite treatment. Hbs Ag loss is a rare event after long term treatment with analogues therapy. In HBe Ag negative patients peg interferon alpha 2a for 96 weeks improved the sustained responses rate by comparison with 48 weeks. It is of interest to know whether the addition of 96 weeks of peg interferon to a long term fully suppressed by nucleoside therapy patients will reduce quantitative HBsAg which may follow by HBs Ag loss.
Methods: We analyzed HBsAg levels of 10 HBe Ag negative patients who received additional peg interferon alpha2a as an individualized therapy during 96 weeks according to the evolution of HBsAg titers. Median baseline HBsAg was 660 IU/ml range (50-1754). Genotype was D in 6 patients. Current treatments were lamivudine (1), adefovir (3), entecavir (2), lamivudine + adefovir (2), adefovir+entecavir (2). HBV DNA was below the limit of detection <20UI/ml in all patients for more than 3 years before interferon therapy. Follow up was available for at least 6 months after the end of peg interferon in all patients.
Results: During add-on of peg interferon, a continuous decline of HBsAg levels was observed in 9 patients. Only one patient remains high and interferon was stopped at week 24. In the remaining 9 patients, HBsAg decline leads to negative values between 24 and 48 weeks in 4 and at 96 weeks of interferon therapy in 1 patient. All antiviral (peg interferon and nucleoside analogue) were stopped in these 5 patients (at 48 weeks in 4 and at the end of interferon therapy in 1) and results remain the same (AgHBs loss and HBV DNA negative) 6 months after cessation of all treatment. In one additional patient, HBsAg titers decreases to 20 UI/ml at the end of the 96 weeks of interferon therapy and reaches negative values 6 months later. HBs serocoversion was obtained in 1/ 6 patients who became HBsAg negative.
Conclusions: In antiHBe positive patients, fully suppressed by long term nucleoside analogue therapy, add-on of peg interferon allow a loss of HBsAg and cessation of all therapy in 6 out of 10 patients. |
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