通过从长期核苷/核苷酸类似物给药到聚乙二醇化干扰素的切

StephenW

J Viral Hepat. 2017 Feb 15. doi: 10.1111/jvh.12691. [Epub ahead of print]
Hepatitis B Surface Antigen Reduction by Switching from Long-term Nucleoside/nucleotide Analog Administration to Pegylated Interferon.Tamaki N1,2, Kurosaki M1,2, Kusakabe A3,2, Orito E3,2, Joko K4,2, Kojima Y5,2, Kimura H6,2, Uchida Y7,2, Hasebe C8,2, Asahina Y9,2, Izumi N1,2.
Author information

• 1Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan.
• 2Japanese Red Cross Hospital Liver Study Group.
• 3Department of Gastroenterology and Hepatology, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Japan.
• 4Department of Gastroenterology and Hepatology, Matsuyama Red Cross Hospital, Matsuyama, Japan.
• 5Department of Gastroenterology and Hepatology, Ise Red Cross Hospital, Ise, Japan.
• 6Department of Gastroenterology and Hepatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan.
• 7Department of Gastroenterology and Hepatology, Matsue Red Cross Hospital, Matsue, Japan.
• 8Department of Gastroenterology and Hepatology, Asahikawa Red Cross Hospital, Asahikawa, Japan.
• 9Department of Hepatitis Control, Tokyo Medical and Dental University, Tokyo, Japan.
  

AbstractHepatitis B surface antigen (HBsAg) reduction during nucleoside/nucleotide analog (NA) therapy is slow and an alternative strategy for patients receiving ongoing NA to facilitate HBsAg reduction is required. We investigated whether switching to pegylated interferon (PEG-IFN) after long-term NA administration enhances HBsAg reduction. Forty-nine patients who switched from long-term NA to 48 weeks of PEG-IFN alfa-2a were studied. The mean duration of previous NA was 48 months (sequential group). A total of 147 patients who continued NA and matched for baseline characteristics were analyzed for comparison (NA continuation group). The treatment response was defined as HBsAg reduction ≥1.0 logIU/ml at the end of PEG-IFN. HBsAg reduction at week 48 was 0.81 ± 1.1 logIU/ml in the sequential group, which was significantly higher than that in the NA continuation group (0.11 ± 0.3 logIU/ml, p <0.001). The treatment response was achieved in 29% and 2% of the sequential group and NA continuation group (p <0.001), and the odds ratio of sequential therapy for treatment response was 19 compared with NA continuation (p <0.001). In patients positive for hepatitis B e antigen (HBeAg), HBeAg seroconversion was higher in the sequential group (44% vs. 8%, p <0.001). In HBeAg negative patients, only patients in the sequential group achieved HBsAg loss. No patient needed to resume NA administration because of HBV DNA increase accompanied by alanine aminotransferase flares. In summary, sequential therapy with PEG-IFN after long-term NA enhances the reduction of HBsAg and may represent a treatment option to promote HBsAg loss. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.

KEYWORDS: Chronic hepatitis B; HBsAg; PEG-IFN; Sequential therapy

PMID:28199034DOI:10.1111/jvh.12691

StephenW

J病毒Hepat。 2017 2月15日。doi：10.1111 / jvh.12691。 [印刷前电子版]
通过从长期核苷/核苷酸类似物给药到聚乙二醇化干扰素的切换，乙型肝炎表面抗原减少。
Tamaki N1,2，Kurosaki M1,2，Kusakabe A3,2，Orito E3,2，Joko K4,2，Kojima Y5,2，Kimura H6,2，Uchida Y7,2，Hasebe C8,2，Asahina Y9,2， Izumi N1,2。
作者信息

    1日本东京的武藏野红十字会医院消化内科和肝病学。
    2日本红十字会医院肝脏研究组。
    日本红十字会名古屋大学医院消化内科和肝脏病学，日本名古屋。
    4日本松山红十字会医院消化内科和肝病学。
    5日本Ise红十字会医院消化内科和肝脏病学。
    6日本红十字会京都第一医院消化内科和肝脏病学，日本京都。
    7日本松江市松江红十字医院消化内科和肝病学部。
    8日本旭川红十字会医院消化内科和肝病学部。
    9日本东京医科牙科大学，肝炎控制科。

抽象

在核苷/核苷酸类似物（NA）治疗期间的乙型肝炎表面抗原（HBsAg）减少是缓慢的，并且需要接受正在进行的NA以促进HBsAg减少的患者的替代策略。我们调查是否切换到聚乙二醇干扰素（PEG-IFN）长期NA管理后增强HBsAg减少。研究了从长期NA转变为48周PEG-IFN alfa-2a的49名患者。以前NA的平均持续时间为48个月（序贯组）。共分析147名持续NA并匹配基线特征的患者进行比较（NA连续组）。治疗反应定义为在PEG-IFN结束时HBsAg降低≥1.0logIU/ ml。在连续组中，第48周的HBsAg减少为0.81±1.1logIU / ml，显着高于NA连续组（0.11±0.3logIU / ml，p <0.001）。治疗反应在连续组和NA连续组的29％和2％（p <0.001）中实现，并且连续治疗对治疗反应的优势比为19比NA连续（p <0.001）。在乙型肝炎e抗原（HBeAg）阳性的患者中，HBeAg血清转换在顺序组中较高（44％对8％，p <0.001）。在HBeAg阴性患者中，只有顺序组中的患者达到HBsAg消失。没有患者需要恢复NA施用，因为HBV DNA增加伴随着丙氨酸氨基转移酶耀斑。总之，长期NA后用PEG-IFN的顺序治疗增强了HBsAg的减少，并且可以代表促进HBsAg消耗的治疗选择。本文受版权保护。版权所有。

本文受版权保护。版权所有。
关键词：

慢性乙型肝炎; HBsAg; PEG-IFN;顺序治疗

PMID：
    28199034
DOI：
    10.1111 / jvh.12691