在后HBeAg阴性慢性乙型肝炎和良好的IL28-B基因型拉米夫定耐药

StephenW

nfez Med. 2016 Jun 1;24(2):144-6.HBsAg seroconversion after pegylated interferon alfa 2a rescue in a lamivudine-resistant patient with HBeAg-negative chronic hepatitis B and favourable IL28-B genotype.Stanzione M1, Stornaiuolo G1, Rizzo V1, Pontarelli A1, Gaeta GB1.
Author information

• 1Infectious Diseases and Viral Hepatitis Unit, Department of Internal and Specialistic Medicine, Second University of Naples, Italy.
  

AbstractHepatitis B virus (HBV) surface antigen (HBsAg) seroconversion to anti-HBs antibody is the best final objective for all available chronic hepatitis B (CHB) treatments. Unfortunately, this goal is rarely achieved with the currently applied therapeutic approaches. Here we describe the case of an anti-HBe-positive CHB patient who was successfully treated with a particular therapeutic schedule. The patient was initially treated with lamivudine (LAM) for nine years. Breakthrough was observed after eight years of LAM therapy. HBV-DNA was 3x10E4 IU/mL and LAM resistance mutations were present. Subcutaneous pegylated interferon (PEG-IFN) alfa 2a, 180 mcg/week, was added to LAM and after 4 weeks LAM was discontinued and PEG-IFN alone was continued up to week 52. HBV-DNA became undetectable at week 4 of therapy; serum HBsAg started to decline from week 4 and became undetectable at week 36, with the subsequent appearance of anti-HBs antibodies. IL28-B was genotyped at the polymorphic site rs12979860 and the CC allele was detected. Rescue therapy with Peg-IFN may be an option for selected patients with resistance to nucleos(t)ide analogues.


PMID:27367326

StephenW

nfez医学。 2016年6月1日; 24（2）：144-6。
在后HBeAg阴性慢性乙型肝炎和良好的IL28-B基因型拉米夫定耐药患者聚乙二醇化干扰素α2a救援乙肝表面抗原血清学转换。
Stanzione M1，Stornaiuolo G1，里佐V1，Pontarelli A1，加埃塔GB1。
作者信息

    1Infectious疾病和病毒性肝炎组，内部的部门和专业式医药，意大利那不勒斯第二大学。

抽象

乙型肝炎病毒（HBV）表面抗原（HBsAg）血清转换到抗HBs抗体是可用于所有慢性乙型肝炎（CHB）的治疗的最佳最终目标。不幸的是，这个目标是很少与当前应用的治疗方法来实现的。在这里，我们描述了一种抗HBe阳性CHB病人谁被成功与特定治疗方案治疗的情况下。患者最初用拉米夫定（LAM）治疗九年。经过八年LAM治疗，观察突破。 HBV-DNA是3x10E4 IU / mL和LAM耐药突变出席了会议。皮下聚乙二醇干扰素（PEG-IFN）干扰素α2a，180微克/周，加入到LAM和4周后林被中断和单独的PEG-IFN持续长达一周52. HBV-DNA成为在治疗4周检测不到;血清HBsAg开始4周下降，并成为36周检测不到，具有抗-HBs抗体随后出场。 IL28-B是在多态型位点rs12979860基因分型，并在检测到的CC等位基因。与聚乙二醇干扰素抢救治疗可能是选择患者对核苷（酸）类似物耐药的选项。

结论：
    27367326