添加聚乙二醇干扰素抗病毒药物对乙肝可导致HBsAg消失

StephenW

Adding Pegylated Interferon to Antivirals for Hepatitis B May Lead to HBsAg Loss

    Written by Liz Highleyman


Addition of pegylated interferon to nucleoside/nucleotide antivirals increases the likelihood of hepatitis B surface antigen (HBsAg) loss -- considered a cure -- in people with hepatitis B "e" antigen (HBeAg) negative chronic hepatitis B, according to a report in December 2013 edition of Journal of Clinical Virology.

Nucleoside/nucleotide analogs such as tenofovir (Viread) or entecavir (Baraclude) effectively suppress hepatitis B virus (HBV) replication, but they usually do not eradicate the virus and may need to be taken long term. Serological response, or changes in hepatitis B antigen and antibody status, is more difficult to achieve than virological response, or undetectable viral load.

Denis Ouzan of Institut Arnault Tzanck in France and colleagues conducted a study to evaluate whether adding pegylated interferon alfa-2a (Pegasys) leads to HBsAg loss in HBeAg negative patients with chronic hepatitis who have fully suppressed HBV DNA on stable long-term nucleoside/nucleotide analog treatment.

This prospective analysis included 10 HBeAg negative but HBsAg positive patients. Before starting pegylated interferon, their HBV viral load had been below the limit of detection for at least 3 years. Treatment with add-on pegylated interferon lasted a maximum of 96 weeks, depending on changes in HBsAg levels.
Results

    HBsAg levels declined in 9 out of 10 patients.
    Among these 9, 4 became HBsAg negative after 48 weeks on pegylated interferon, and they stopped interferon at that point.
    These 4 patients also stopped nucleoside/nucleotide analogs, and HBsAg remained negative and HBV DNA remained undetectable for at least 18 months.
    2 patients experienced HBs seroconversion.
    The 5 patients without early HBsAg decline received pegylated interferon for 96 weeks.
    1 patient became HBsAg negative at the end of interferon therapy, while another became HBsAg negative 6 months later.
    Both stopped nucleoside/nucleotide analogs and did not relapse during 12 months of follow up.
    The remaining 3 patients never became HBsAg negative.

Based on these findings, the study authors concluded, "In HBsAg positive, HBeAg negative patients with HBV DNA fully suppressed by long-term NA treatment, the addition of pegylated interferon for a maximum of 96 weeks based on HBsAg titer monitoring led to a loss of HBsAg and cessation of NA therapy in 6 out of 10 patients, with no relapse for 12-18 months of follow up."

12/23/13

Reference

D Ouzan, G Pénaranda, H Joly, et al. 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. Journal of Clinical Virology 58(4):713-717. December 2013.

StephenW

添加聚乙二醇干扰素抗病毒药物对乙肝可导致HBsAg消失

在本周一发布， 2013年12月23日00:00
    写由Liz Highleyman


除了聚乙二醇干扰素核苷/核苷酸抗病毒药物增加乙肝表面抗原的可能性（ HBsAg）的损失 - 被认为是治愈 - 在人与B型肝炎的“e”抗原（HBeAg ）阴性慢性乙型肝炎，根据报告2013年12月版的杂志临床病毒学杂志的。

核苷/核苷酸类似物如替诺福韦（ Viread的）或恩替卡韦（博路定）有效地抑制乙肝病毒（HBV ）的复制，但他们通常不会消除病毒，并可能需要采取长期的。血清学应答，或改变乙型肝炎抗原和抗体的状态，是比较难以实现比病毒学应答，或者不可检测的病毒载量。

学院阿尔诺Tzanck在法国的丹尼斯Ouzan和同事进行了一项研究，以评估是否加入聚乙二醇化干扰素α-2a （派罗欣）导致损失的HBsAg HBeAg阴性慢性乙型肝炎患者谁已经完全抑制HBV DNA的长期稳定的核苷/核苷酸模拟处理。

本前瞻性分析包括10 HBeAg阴性，但乙肝表面抗原阳性患者。开始聚乙二醇干扰素之前，他们的乙肝病毒载量一直低于检测限为至少3年。治疗与附加聚乙二醇干扰素历时最长96周，这取决于变化HBsAg水平。
结果

    HBsAg水平在9出10例下降。
    其中9,4成为HBsAg阴性48周对聚乙二醇干扰素后，他们停止干扰素在这一点上。
    这4例患者也停止核苷/核苷酸类似物，与HBsAg持续阴性， HBV DNA检测不到保持在至少18个月。
    2患者出现血清转换HBs阳性。
    5例患者无早HBsAg的下降接到聚乙二醇干扰素96周。
    1名患者成为HBsAg阴性在干扰素治疗结束时，而另一个成为HBsAg阴性后6个月。
    双方停止核苷/核苷酸类似物，并在后续上涨12个月未复发。
    其余3例患者从来没有成为HBsAg阴性。

基于这些发现，研究人员得出结论， “在HBsAg阳性， HBeAg阴性患者HBV DNA长期NA治疗完全压制，除了聚乙二醇干扰素最多96周的基础上的HBsAg滴度监测导致的损失的HBsAg和停止NA治疗的6出10例患者，无复发为12-18个月随访的“ 。

13年12月23日

参考

ð Ouzan ，G佩尼亚兰达，H乔利等。附加PEG-干扰素导致HBsAg的患者HBeAg阴性慢性乙型肝炎和HBV DNA长期核苷酸类似物完全抑制损失。中国临床病毒学杂志58 （ 4 ） :713 -717 。 2013年12月。

疯一点好

好消息啊，好像国内也有类似的报道，不管如何，希望能够利用现有的抗病毒药物达到消灭乙肝的目的。

9病成医