慢性乙型肝炎患者乙型肝炎表面抗原水平的动力学在聚乙二

StephenW

Chin Med J (Engl). 2017 5th Mar;130(5):559-565. doi: 10.4103/0366-6999.200554.
Kinetics of Hepatitis B Surface Antigen Level in Chronic Hepatitis B Patients who Achieved Hepatitis B Surface Antigen Loss during Pegylated Interferon Alpha-2a Treatment.Li MH1, Zhang L1, Qu XJ1, Lu Y1, Shen G1, Wu SL1, Chang M1, Liu RY1, Hu LP1, Li ZZ1, Hua WH2, Song SJ2, Xie Y1.
Author information

• 1Liver Diseases Center, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.
• 2Clinical Test Center, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.
  

AbstractBACKGROUND: Hepatitis B surface antigen (HBsAg) loss/seroconversion is considered to be the ideal endpoint of antiviral therapy and the ultimate treatment goal in chronic hepatitis B (CHB). This study aimed to assess the patterns of HBsAg kinetics in CHB patients who achieved HBsAg loss during the treatment of pegylated interferon (PEG-IFN) α-2a.
METHODS: A total of 150 patients were enrolled, composing of 83 hepatitis B envelope antigen (HBeAg)-positive and 67 HBeAg-negative patients. Patients were treated with PEG-IFN α-2a180 μg/week until HBsAg loss/seroconversion was achieved, which occurred within 96 weeks. Serum hepatitis B virus deoxyribonucleic acid and serological indicators (HBsAg, anti-HBs, HBeAg, and anti-HBe) were determined before and every 3 months during PEG-IFN α-2a treatment. Biochemical markers and peripheral blood neutrophil and platelet counts were tested every 1-3 months.
RESULTS: Baseline HBsAg levels were 2.5 ± 1.3 log IU/ml, and decreased rapidly at 12 and 24 weeks by 48.3% and 88.3%, respectively. The mean time to HBsAg loss was 54.2 ± 30.4 weeks, though most patients needed extended treatment and 30.0% of HBsAg loss occurred during 72-96 weeks. Baseline HBsAg levels were significantly higher in HBeAg-positive patients (2.9 ± 1.1 log IU/ml) compared with HBeAg-negative patients (2.0 ± 1.3 log IU/ml; t = 4.733, P < 0.001), but the HBsAg kinetics were similar. Patients who achieved HBsAg loss within 48 weeks had significantly lower baseline HBsAg levels and had more rapid decline of HBsAg at 12 weeks compared to patients who needed extended treatment to achieve HBsAg loss.
CONCLUSIONS: Patients with lower baseline HBsAg levels and more rapid decline during early treatment with PEG-IFN are more likely to achieve HBsAg loss during 96 weeks of treatment, and extended therapy longer than 48 weeks may be required to achieve HBsAg loss.


PMID:28229987DOI:10.4103/0366-6999.200554

StephenW

Chin Med J（Engl）。 2017 5th Mar; 130（5）：559-565。 doi：10.4103 / 0366-6999.200554。
慢性乙型肝炎患者乙型肝炎表面抗原水平的动力学在聚乙二醇化干扰素α-2a治疗期间达到乙型肝炎表面抗原损失。
Li MH1，Zhang L1，Qu XJ1，Lu Y1，Shen G1，Wu SL1，Chang M1，Liu RY1，Hu LP1，Li ZZ1，Hua WH2，Song SJ2，Xie Y1。
作者信息

    1首都医科大学北京第二医院肝病中心，北京100015。
    2临床试验中心，首都医科大学北京Ditan医院，北京100015。

抽象
背景：

乙型肝炎表面抗原（HBsAg）损失/血清转换被认为是慢性乙型肝炎（CHB）的抗病毒治疗和最终治疗目标的理想终点。本研究旨在评估在聚乙二醇化干扰素（PEG-IFN）α-2a治疗期间达到HBsAg消失的CHB患者的HBsAg动力学模式。
方法：

总共150名患者入组，由83名乙型肝炎包膜抗原（HBeAg）阳性和67名HBeAg阴性患者组成。患者用PEG-IFNα-2a180μg/周治疗，直到达到HBsAg丧失/血清转化，其发生在96周内。在PEG-IFNα-2a治疗前和每3个月测定血清乙型肝炎病毒脱氧核糖核酸和血清学指标（HBsAg，抗HBs，HBeAg和抗HBe）。每1-3个月测试生化标记物和外周血中性粒细胞和血小板计数。
结果：

基线HBsAg水平为2.5±1.3log IU / ml，在12和24周快速降低48.3％和88.3％。 HBsAg消失的平均时间为54.2±30.4周，尽管大多数患者需要延长治疗，并且在72-96周期间发生30.0％的HBsAg消失。与HBeAg阴性患者（2.0±1.3log IU / ml; t = 4.733，P <0.001）相比，HBeAg阳性患者（2.9±1.1log IU / ml）的基线HBsAg水平显着更高，但HBsAg动力学类似。与需要延长治疗以实现HBsAg消失的患者相比，在48周内达到HBsAg消失的患者具有显着较低的基线HBsAg水平和在12周时HBsAg的更快速下降。
结论：

在用PEG-IFN早期治疗期间具有较低基线HBsAg水平和更快速下降的患者更可能在96周的治疗期间实现HBsAg消失，并且可能需要长于48周的延长疗法来实现HBsAg消耗。

PMID：
    28229987
DOI：
    10.4103 / 0366-6999.200554