8周聚乙二醇化干扰素α-2a或核苷类似物治疗对中国慢性乙型

StephenW

Virol J. 2017 Mar 9;14(1):49. doi: 10.1186/s12985-017-0712-x.
Effect of 48-week pegylated interferon α-2a or nucleos(t)ide analogue therapy on renal function in Chinese patients with chronic hepatitis B.Zhang Y1, Zhang WL2, Pang XW3,4, Wang LX1, Wei X1, Huang CX1, Bai XF1, Han S5, Liu LN6, Lian JQ7.
Author information
1Center for Infectious Diseases, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Rd, Xi'an, China.2Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi'an, China.3Department of Oncology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.4Department of Medical Quality Management, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.5The First Brigade of Student, Fourth Military Medical University, Xi'an, China.6Department of Pharmaceutics, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Rd, Xi'an, China. [email protected].7Center for Infectious Diseases, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Rd, Xi'an, China. [email protected].

AbstractBACKGROUND: Controversy remains as to whether antiviral agents contribute to renal dysfunction in patients with chronic hepatitis B virus (HBV) infection. Thus, the aim of study was to analyze the changes in renal function of chronic hepatitis B (CHB) patients in response to anti-HBV therapy and the association with treatments.
METHOD: We performed a retrospective observational cohort study to investigate factors associated with renal function in 249 Chinese CHB patients who were treated with pegylated interferon α-2a (PEG-IFN-α-2a) or nucleos(t)ide analogues for 48 weeks. Changes of estimated glomerular filtration rate (eGFR), which was computed with both the Chronic Kidney Disease Epidemiology Collaboration and the Modification of Diet in Renal Disease formulas, were tested by repeated measures One-way analysis of variance within groups. A linear mixed effects model for repeated measures was also used to evaluate the association between baseline information and eGFR changes over time in all enrolled patients. The model considered the baseline age, sex, HBV DNA, aminotransferase, blood urea nitrogen, treatment group, time, and group-by-time interaction as fixed effects and incorporated random effects for individual subjects.
RESULTS: The eGFR increased in patients given PEG-IFN-α-2a, decreased in patients given adefovir, but remained stable in patients given entecavir. Age and blood urea nitrogen were significant negative predictive factors for eGFR changes.
CONCLUSION: In real-life study, PEG-IFN-α-2a therapy in CHB patients increased eGFR, thus may associate with renoprotective effects when compared with adefovir or entecavir therapies.


KEYWORDS: Antiviral; Chronic hepatitis B; Chronic kidney diseases; Drug; Mixed Linear Model

PMID:28274240DOI:10.1186/s12985-017-0712-x

StephenW

Virol J.2017 Mar 9; 14（1）：49。 doi：10.1186 / s12985-017-0712-x。
48周聚乙二醇化干扰素α-2a或核苷类似物治疗对中国慢性乙型肝炎患者肾功能的影响。
Zhang Xl，Zhang XL2，Pang XW3,4，Wang LX1，Wei X1，Huang CX1，Bai XF1，Han S5，Liu LN6，Lian JQ7。
作者信息

1
    第四军医大学唐都医院传染病中心，西安市新秀路569号。
2
    中国西安第四军医大学公共卫生学院流行病学系。
3
    中国西安市第四军医大学唐都医院肿瘤科。
4
    中国西安第四军医大学唐都医院医学质量管理系。
5
    中国西安第四军医大学学生第一旅。
6
    第四军医大学唐都医院药学系，西安市新秀路569号。 [email protected]。
7
    第四军医大学唐都医院传染病中心，西安市新秀路569号。 [email protected]。

抽象
背景：

关于抗病毒剂是否有助于慢性乙型肝炎病毒（HBV）感染患者的肾功能障碍仍有争议。因此，研究的目的是分析慢性乙型肝炎（CHB）患者响应于抗HBV治疗的肾功能的变化和与治疗的关联。
方法：

我们进行回顾性观察队列研究以调查与中枢CHB患者聚乙二醇干扰素α-2a（PEG-IFN-α-2a）或核苷（类似物）治疗48周的肾功能相关的因素。使用慢性肾脏疾病流行病学合作和肾脏疾病公式中饮食的修改计算的估计肾小球滤过率（eGFR）的变化通过重复测量通过组内方差的单因素分析来测试。重复测量的线性混合效应模型也用于评估所有入选患者的基线信息和eGFR随时间的变化之间的关联。该模型将个体受试者的基线年龄，性别，HBV DNA，氨基转移酶，血尿素氮，治疗组，时间和逐时相互作用作为固定效应和并入随机效应。
结果：

在给予PEG-IFN-α-2a的患者中eGFR增加，在给予阿德福韦的患者中eGFR减少，但在给予恩替卡韦的患者中eGFR增加。年龄和血尿素氮是eGFR变化的显着阴性预测因素。
结论：

在现实生活研究中，PEG-IFN-α-2a治疗CHB患者增加eGFR，因此与阿德福韦或恩替卡韦治疗相比，可能与肾脏保护作用相关。
关键词：

抗病毒;慢性乙型肝炎;慢性肾脏疾病;药物;混合线性模型

PMID：
    28274240
DOI：
    10.1186 / s12985-017-0712-x