HBeAg阴性长期核苷酸类似物添加PEG-干扰素导致hbsag损失

StephenW

Add-on peg-interferon leads to loss of HBsAg in patients with HBeAg-negative chronic hepatitis and HBV DNA fully suppressed by long-term nucleotide analogs

• Denis Ouzan
  ,
• Guillaume Pénaranda
  ,
• Hélène Joly
  ,
• Hacène Khiri
  ,
• Antonnella Pironti
  ,
• Philippe Halfon
  

Received 24 May 2013; received in revised form 19 September 2013; accepted 21 September 2013. published online 04 November 2013.
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Abstract Background and objective

The aim of this study was to prospectively evaluate whether the addition of peg-IFN to a stable NA regimen leads to loss of HBsAg in HBeAg-negative patients with chronic hepatitis and HBV DNA fully suppressed by long-term NA treatment.

Study design

We analyzed HBsAg levels in 10 HBsAg-positive, HBeAg-negative patients who received peg-IFN alpha-2a in addition to a NA regimen. Treatment lasted a maximum of 96 weeks, according to changes in the HBsAg titer. Before peg-IFN therapy, HBV DNA levels had been below the limit of detection for at least three years.

Results

HBsAg levels declined in nine patients. Among these nine, four became HBsAg-negative after 48 weeks of peg-IFN treatment; these patients received peg-IFN for only 48 weeks. NAs were stopped in these four patients, and these levels remained stable for at least 18 months (loss of HBsAg; HBV-DNA negative). HBs seroconversion was observed in two patients. The remaining five patients received 96 weeks of peg-IFN therapy. One patient became HBsAg-negative at the end of peg-IFN therapy; another became HBsAg-negative six months later. Three patients did not become HBsAg-negative. NAs were stopped in the two patients who became HBsAg-negative with no relapse during 12 months of follow up.

Conclusions

In HBsAg-positive, HBeAg-negative patients with HBV DNA were fully suppressed by long-term NA treatment, the addition of peg-INF for a maximum of 96 weeks based on HBsAg-titer monitoring led to a loss of HBsAg and cessation of NA therapy in six out of ten patients, with no relapse for 12–18 months of follow up. HBs seroconversion was observed in two patients.

StephenW

10例HBeAg阴性患者，NA治疗，HBVDNA检测不到，至少3年以上.


添加PEG-干扰素，至少48周，最大96周
9例HBsAg水平下降了.
4成为PEG-IFN治疗48周后HBsAg阴性;NAS停止, 至少18个月 HBsAg阴性，HBVDNA检测不到。有2 /4获得的抗体.


余下的5收96周的P​​EG-intereferon.
1例患者成为HBsAg阴性 96周结束时。另一名病人成为HBsAg阴性6个月后.在这2患者中，NAS停下来，在12个月随访无复发.
3患者没有成为HBsAg阴性。

别愁

10个人最后有6个表抗原转阴，比例很高啊。就是不知道他们干扰前HBsAg的数量如何。

StephenW

回复 别愁 的帖子

是的，非常重要的一点。我也想知道他们的基因型。

beidedise

这数据很邪乎。
我怀疑它的真实性。

StephenW

回复 beidedise 的帖子

研究是从法国，在临床病毒学杂志出版journal of clinical virology.

齐欢畅2

mark

重肝过后

样本数少了点

StephenW

图1：在六成为乙肝表面抗原阴性患者的HBsAg滴度。在这些
患者中，NA方案停止当病人成为的HBsAg seronegative的的。小虚线（绿色）代表四个成为乙肝表面抗原阴性的患者在48周（PEG-IFN和NA被拦在W48），实线（蓝色）代表两患者在其中HBsAg水平下降，但并没有成为不到W48（PEG-IFN历时96周）。 HBsAg水平是高度异质性的患者。因此，形式上的突破代表这些值的中轴线;规模应解释
Figure 1: HBsAg titers in the six patients who became HBsAg-seronegative. In these
patients, the NA regimen was stopped when the patient became HBsAg-eronegative. The small dotted lines (green) represent the four patients who became HBsAg-seronegative at 48 weeks (peg-IFN and NA were stopped at W48); the solid lines (blue) represent the two patients in whom HBsAg levels decreased but did not become undetectable at W48 (peg-IFN lasted for 96 weeks). HBsAg levels were highly heterogeneous among patients. Thus, thereis a break in the axis representing these values; the scale should be interpreted accordingly.

StephenW

图2：在四
个没有成为乙肝表面抗原阴性患者的HBsAg滴度。在这些
患者的NA方案保持。大型虚线（蓝色）代表了三个患者在其中HBsAg水平下降，但并没有成为检测不到（PEG-IFN历时96周）大（红色虚线）表示在其中病人HBsAg水平仍然高企在W24（ PEG-IFN被拦在W24）。 HBsAg的值是高度异质性的患者。因此，有在轴表示这些值是一个突破规模应相应地解释

Figure 2: HBsAg titers in the four patients who did not became HBsAg-seronegative. In these
patients, the NA regimen was maintained. The large dotted lines (blue) represent the three patients in whom HBsAg levels decreased but did not become undetectable (peg-IFN lasted for 96 weeks); the large dotted line (red) represents the patient in whom HBsAg levels remained high at W24 (peg-IFN was stopped at W24). Values of HBsAg were highly heterogeneous among patients. Thus, there is a break in the axis representing these values; the scale should be interpreted accordingly