血清乙肝表面抗原的定量 在预测聚乙二醇干扰素的反应 HBeAg

StephenW

Quantification of serum hepatitis B surface antigen
in predicting the response of pegylated interferon
alfa-2a in HBeAg-positive chronic hepatitis B with
prior lamivudine exposure
Min Weng1
Email: [email protected]
Wei-Zheng Zeng1*
* Corresponding author
Email: [email protected]
Xiao-Ling Wu1
Email: [email protected]
Yong Zhang1
Email: [email protected]
Ming-De Jiang1
Email: [email protected]
Zhao Wang1
Email: [email protected]
De-Jiang Zhou1
Email: [email protected]
Xuan He1
Email: [email protected]
1 Department of Digestion, General Hospital of Chengdu Military Region of
PLA, Chengdu, Sichuan Province, People’s Republic of China

Aims

Majority of previous studies of pegylated interferon alpha-2a (PegIFNalpha-2a) forced on naive chronic hepatitis B (CHB) patients, and the data of PegIFNalpha-2a in therapy of patients with prior exposure to nucleos(t)ide analogues is rare. This study aimed to investigate the predictive role of serum quantitative hepatitis B surface antigen (HBsAg) in predicting sustained response of PegIFNalpha-2a in HBeAg-positive CHB patients with prior lamivudine exposure.
Methods

Forty-six patients with prior lamivudine exposure received PegIFNalpha-2a for 12 months and followed-up for 6 months. The clinical features of responders and non-responders were compared, and the predictive role of quantitative HBsAg in predicting responders at the end of follow-up was evaluated. Responders were defined as an ALT normalization, HBeAg seroconversion and sustained virological response at the end of follow-up.
Results

In this cohort, only 26.1% (12/46) patients were responders. The baseline characteristics of the responders and non-responders were similar; however, the rates of ALT normalization, HBV DNA undetectability and HBeAg seroconversion were all significantly higher in responders than that in non-responders. During the treatment and follow-up, the HBsAg levels were all significantly lower in responders than that in non-responders. In predicting reponders, the serum HBsAg cutoff of 6000 IU/mL at months 6 had a positive predictive value of 73.3 and a negative predictive value of 96.8%, and with an area under the receiver operating characteristic curve of 0.869.
Conclusion

The responders toward PegIFNalpha-2a in CHB patients with prior lamivudine exposure is not high, and serum HBsAg <6000 IU/Ml at months 6 of on-treatment had a high value to predict long-term outcomes of treatment.

StephenW

血清乙肝表面抗原的定量
在预测聚乙二醇干扰素的反应
HBeAg阳性慢性乙型肝炎的干扰素α-2a
前拉米夫定曝光
闵Weng1
电子邮件： [email protected]
魏正增1 *
*通讯作者
电子邮件： [email protected]
小玲武1
电子邮件： [email protected]
勇张心
电子邮件： [email protected]
铭德江1
电子邮件： [email protected]的
赵Wang1
电子邮件： [email protected]
德江舟
电子邮件： [email protected]
玄鹤1
电子邮件： [email protected]
1成都军区总医院消化内科
解放军，成都，四川省中华人民共和国

旨在

天真慢性乙型肝炎（ CHB ）患者，聚乙二醇干扰素α- 2a干扰素（ PegIFNalpha - 2A）以往的研究多数被迫的的数据PegIFNalpha -2A之前曝光核苷（酸）类似物治疗的患者中是罕见的。本研究旨在探讨血清定量乙肝表面抗原（HBsAg）在预测持续响应之前拉米夫定暴露在HBeAg阳性CHB患者的PegIFNalpha - 2A的预测作用。
方法

之前拉米夫定曝光46例接受PegIFNalpha -2a的12个月，随访6个月。反应者和无应答者的临床特征进行了比较，并进行了评估预测应答随访结束时HBsAg定量的预测作用。 ALT复常者定义，随访结束时HBeAg血清学转换和持续病毒学应答。
结果

在这个群体中，只有26.1 ％ （ 12 /46）的患者有反应。的反应和非反应的基线特征相似，但是， ALT复常， HBV DNA不可检测和HBeAg血清转换率都显着高于无应答者的反应比。在治疗和随访， HBsAg水平都显着较低的比无应答者的反应。在预测reponders ，血清HBsAg截止6000 IU / mL的在6个月的阳性预测值73.3和96.8％ ，阴性预测值为，受试者工作特征曲线下面积为0.869 。
结论

之前拉米夫定暴露在CHB患者向PegIFNalpha - 2A的应答是不高，而且，血清HBsAg < 6000 IU /毫升， 6个月的治疗有很高的价值，预测长期治疗的结果。

咬牙硬挺

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