PEG-干扰素α-2a的联合阿德福韦乙肝病毒产后妇女与ALT水平正

StephenW

Effect of Peg-interferon α-2a combined with Adefovir in HBV postpartum women with normal levels of ALT and high levels of HBV DNA

    Junfeng Lu1,†, Shibin Zhang1,†, Yali Liu1, Xiaofei Du1, Shan Ren1, Hua Zhang1, Lina Ma1, Yue Chen2, Xinyue Chen1,‡,* andChengli Shen2,‡,*

Article first published online: 21 JAN 2015

DOI: 10.1111/liv.12753

© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

Issue
Liver International
Liver International

Volume 35, Issue 6, pages 1692–1699, June 2015

    1    International Medical Department, Beijing Youan Hospital, Capital Medical, Beijing, China
    2    Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, USA

    †    These authors contributed equally to the work.
    ‡    co-corresponding authors.

* Correspondence
Xinyue Chen, International Medical Department, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China.
Tel: +86 10 83997000
Fax: +86 10 63054847
e-mail: [email protected]
Chengli Shen, Infectious Diseases & Microbiology Pitt Public Health, School of Medicine, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA 15261-5454, USA
Tel: +1 412 383 8694
Fax: +1 412 624 4953
e-mail: [email protected]


Keywords:

    chronic hepatitis B;normal levels of ALT and high levels of HBV DNA;pegylated interferon α-2a;pregnant woman

Abstract
Background & Aims

Currently, routine antiviral treatment is not recommended for immune-tolerant subjects with chronic HBV infection. In this study, we assessed the treatment efficacy of combining Peg IFN α-2a with Adefovir (CPIA) in chronic HBV infected pregnant women with normal levels of ALT and high levels of HBV after delivery.
Methods

Chronic hepatitis B pregnant women with normal levels of ALT and high levels of HBV DNA were treated with Telbivudine during the third trimester of their pregnancy. After childbirth, based on serological and virological parameters, the patients were either switched to CPIA treatment for 96 weeks or stopped Telbivudine treatment and followed for 48 weeks.
Results

A total of 68 patients were enrolled in this study. Thirty (30/68) of them were switched to CPIA treatment after childbirth, 93.3% (28/30) of them achieved virological response, 56.7% (17/30) achieved HBeAg seroclearance and 26.7% (8/30) cleared HBsAg. The HBV DNA and HBeAg levels before CPIA treatment were negatively associated with HBeAg seroclearance. HBsAg and HBeAg levels in week 12 and week 24 after CPIA treatment were negatively associated with HBsAg seroclearance. Thirty-eight (38/68) patients did not receive antiviral treatment after childbirth, and none of them had HBeAg or HBsAg clearance.
Conclusion

High rates of viral response and clearance were achieved in chronic hepatitis B pregnant woman with normal levels of ALT and high levels of HBV DNA treated by CPIA after childbirth. (231 words).

StephenW

PEG-干扰素α-2a的联合阿德福韦乙肝病毒产后妇女与ALT水平正常和高水平的HBV DNA的影响

    俊峰璐，†，柿槟Zhang1，†，雅礼Liu1，小菲DU1，山REN1，华Zhang1，丽娜MA1，岳Chen2，欣悦臣1，‡，* andChengli Shen2，‡*

文章首次在线发表：2015年1月21日

DOI：10.1111 / liv.12753

2014年©约翰·威利父子A / S。由John Wiley＆Sons出版有限公司

问题
肝国际
肝国际

第35卷，第6期，页1692至1699年，2015年6月

    1国际医学部，北京佑安医院，首都医科大学，北京，中国
    传染病2系和微生物学，公共卫生，匹兹堡大学，匹兹堡，美国研究生院

    †这些作者同等贡献的工作。
    ‡共同通讯作者。

*通讯
新月陈，国际医疗部，北京佑安医院，首都医科大学，北京100069，中国。
电话：+86 10 83997000
传真：+86 10 63054847
电子邮件：[email protected]
程力沉，传染病和微生物学碧公共卫生，医学院，匹兹堡大学，德索托街130，匹兹堡，宾夕法尼亚州15261-5454，USA
联系电话：+1 412 383 8694
传真：+1 412 624 4953
电子邮件：[email protected]


关键词：

    慢性乙型肝炎; ALT和高水平的HBV DNA的正常水平;聚乙二醇化干扰素α-2a的;孕妇

抽象
背景与目的

目前，常规抗病毒治疗不推荐用于慢性HBV感染免疫耐受者。在这项研究中，我们评估钉干扰素α-2a的结合阿德福韦（CPIA）在慢性HBV感染的孕妇与ALT水平正常和高水平HBV分娩后的疗效。
方法

慢性乙肝孕妇ALT水平正常和高水平的HBV DNA均与替比夫定怀孕的第三孕期治疗。分娩后，根据血清学和病毒学参数，患者要么改用CPIA治疗96周或停止替比夫定治疗和随访48周。
结果

共有68例患者参加了这项研究。三十人（30/68）被切换到CPIA治疗分娩后，他们中的93.3％（28/30），实现了病毒学应答，56.7％（17/30），实现e抗原血清学清除和26.7％（8/30），乙肝表面抗原清除。 CPIA治疗前HBV DNA和HBeAg水平呈负的HBeAg血清学清除相关。 HBsAg和HBeAg水平在24周12周和CPIA治疗后负的HBsAg血清清除相关。三十八年（68分之38）的患者未接受抗病毒治疗，分娩后，和他们都没有大三阳或HBsAg清除。
结论

病毒应答和清除率高​​是在慢性乙肝孕妇ALT水平正常和高水平的HBV DNA分娩后CPIA处理来实现的。 （231字）。

小民百姓

肝功正常，但DNA血清定量高的产妇在经过长效干扰素和阿德联合用药后，e抗原和表面抗原得到了血清转换，有效率还不低。这是为什么？是不是孕妇可以分泌天然的抗病毒物质，目前不知道这是什么物质？要是搞清楚这是什么物质，把它制成药物…这可是乙肝新药的一个好的启发！