因素预测连续核苷（t）的IDE模拟，IFN-α治疗的反应确定

StephenW

Factors predictive of sequential nucleos(t)ide analogue, IFN-α therapy response identified
Published on March 13, 2015 at 5:15 PM · No Comments

  
By Shreeya Nanda, Senior medwireNews Reporter

Hepatitis B surface antigen (HBsAg) and hepatitis B core-related antigen (HBcrAg) levels can predict long-term response to sequential nucleos(t)ide analogue and interferon-α (IFN-α) therapy in patients with chronic hepatitis B virus (HBV) infection, research indicates.

Researcher Eiji Tanaka (Shinshu University School of Medicine, Matsumoto, Japan) and colleagues also report that maximal levels of alanine aminotransferase (ALT) and HBV DNA during follow-up could be useful for monitoring response to sequential treatment.

This retrospective study included 50 chronic HBV patients treated with a nucleos(t)ide analogue plus IFN-α for 4 weeks followed by IFN-α alone for 20 weeks, with the aim of identifying “factors associated with a long-term response to IFN-α sequential therapy in order to safely discontinue [nucleos(t)ide analogue] therapy”.

After a follow-up of 24 months, 18 participants had serum HBV DNA lower than 4.0 log copies/mL, serum ALT below 30.0 IU/L and were negative for hepatitis B e antigen (HBeAg), and as such were deemed as responders. The remaining 32 did not fulfil these clinical criteria and were classified as nonresponders.

Multivariate analysis showed that individuals with HBsAg levels of 3.0 log IU/mL or higher and HBcrAg levels of 4.5 log U/mL or higher when IFN-α treatment was initiated were significantly less likely to respond to sequential therapy at 24 months than individuals with lower levels.

And receiver operating characteristic (ROC) analysis revealed a significant association between treatment response and maximal ALT and HBV DNA levels, with area under the curve values of 0.839 and 0.868, respectively.

The researchers identified cutoff values of 128 IU/L for ALT and 6.0 log copies/mL for HBV DNA levels, such that patients with levels greater than these during post-treatment follow-up were “likely to be non-responders”.

Using the ALT cutoff to define relapse, they found that most instances of relapse occurred during the initial 24 weeks after IFN-α treatment was stopped, a time period generally considered to be an appropriate monitoring time, they note.

“Accordingly, patients who are likely to be non-responders can now be identified as early as 24 weeks in advance and alternative strategies for treatment may be considered in a more timely fashion”, the team concludes in Hepatology Research.

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StephenW

因素预测连续核苷（t）的IDE模拟，IFN-α治疗的反应确定
发布于2015年3月13日在5:15 PM·没有评论

  
通过Shreeya南大，高级medwireNews记者

B型肝炎表面抗原（HBsAg）和乙肝核心相关抗原（HBcrAg）水平可以预测长期响应于连续的核苷（酸）IDE类似物和干扰素α（IFN-α）治疗慢性乙型肝炎病毒（ HBV）感染，研究表明。

研究员田中英二（信州大学医学院，松本，日本）和他的同事还报告说，谷丙转氨酶（ALT）和HBV DNA的随访期间最高水平可能是用于监视响应连续治疗。

这一回顾性研究包括用核苷（酸）IDE类似物加IFN-α4周，然后单独的IFN-α20周治疗，以识别“的因素的一个长期响应于干扰素相关联的目标50的慢性HBV患者-α序贯疗法，以便安全地停止[核苷（酸）类似物IDE]疗法“。

经过随访24个月，18名学员的血清HBV DNA低于4.0日志拷贝/ ml，血清ALT低于30.0 IU / L和阴性乙肝e抗原（HBeAg），因此被视为反应。其余的32并没有满足这些临床标准，被列为无反应。

多因素分析表明，随着3.0 HBsAg水平的个人日志IU / mL或更高，HBcrAg水平4.5日志U / mL或更高时，IFN-α治疗开始是显著不太可能在比低的个体24个月回应序贯疗法水平。

和受试者工作特征（ROC）分析显示下的0.839和0.868，分别的曲线值的治疗反应和最大ALT和HBV DNA水平之间的显著关联，与面积。

研究人员确定为128 IU / L截止值ALT和6.0日志拷贝/毫升为HBV DNA水平，使得患者在治疗后大于这些水平的后续者“可能是无反应者”。

使用ALT截止来定义复发，他们发现复发的大多数情况下，后IFN-α处理停止，一般被认为是适当的监视时间的时间段期间的前24周中产生了，他们指出。

“因此，患者谁可能是无反应者现在可以标识为早24周提前和替代策略处理可以以更及时的方式被认为是”，该球队的结论在肝病研究。

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