干扰素治疗慢性乙型肝炎患者乙型肝炎表面抗原滴度降低的

StephenW

Biomed Rep. 2017 Sep;7(3):257-262. doi: 10.3892/br.2017.944. Epub  2017 Jul 18.
Factors associated with the decrease in hepatitis B surface antigen titers following interferon therapy in patients with chronic hepatitis B: Is interferon and adefovir combination therapy effective?Yano Y1,2, Seo Y3, Hayashi H2, Hatazawa Y2, Hirano H2, Minami A2, Kawano Y2, Saito M4, Ninomiya T5, Sugano M6, Yamada H7, Kitajima N8, Yoon S9, Hayashi Y2.
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AbstractThe purpose of antiviral therapy in chronic hepatitis B (CHB) is generally to achieve a decrease and ultimately disappearance of HBs antigen (HBsAg). Interferon (IFN) therapy of CHB appears to be less effective in Asian countries than in European countries, and the advantage of IFN and nucleotide(s) analog (NA) combination therapy has yet to be fully investigated. The present study focused on the factors associated with a decrease in HBs antigen following IFN monotherapy or IFN + NA combination therapy. A total of 35 patients with CHB who received IFN-based therapy (mean ± standard deviation age 36.7±8.5 years; 27 males and 8 females) were enrolled in this study. Of the 35 patients, 21 patients received pegylated IFN monotherapy and 14 patients received IFN and adefovir (ADV) combination therapy. We examined the factors associated with reductions in the HBsAg titer of >1.0 log IU/ml from the initial HBsAg titer to the end of treatment and to 24 weeks after treatment. Although 13 patients (37%) had a reduction in HBsAg of >1.0 IU/ml at the end of treatment, it was only maintained to 24 weeks after treatment in 7 patients (20%). The HBV core-related antigen (HBcrAg) titer before treatment was significantly higher in patients with a decrease in HBsAg at the end of treatment than in patients without a decrease in HBsAg (6.56±0.78 vs. 5.30±1.66 log IU/ml, P<0.05). Moreover, an increase in alanine aminotransferase (ALT) of >2 times from baseline occurred significantly more frequently in patients with a decrease in HBsAg (62 vs. 14%, P<0.05). The proportion of patients with a decrease in HBsAg was significantly greater in patients who received IFN monotherapy than in patients who received IFN and ADV combination therapy (43 vs. 29%, P<0.05). The present results revealed that the HBcr antigen titer before therapy and an on-treatment elevation of ALT (indicative of host instruction flare) are important factors associated with a decrease in HBsAg titers after IFN-based therapy. The efficacy of IFN and ADV combination therapy was not apparent in terms of a reduction in the HBsAg titer.


KEYWORDS: HBcr antigen; HBs antigen; adefovir; hepatitis B virus; interferon

PMID:28819561PMCID:PMC5549598DOI:10.3892/br.2017.944

StephenW

Biomed Rep。2017 Sep; 7（3）：257-262。 doi：10.3892 / br.2017.944。 Epub 2017 Jul 18。
干扰素治疗慢性乙型肝炎患者乙型肝炎表面抗原滴度降低的因素是干扰素和阿德福韦联合治疗有效吗？
Yano Y1,2，Seo Y3，Hayashi H2，Hatazawa Y2，Hirano H2，Minami A2，Kawano Y2，Saito M4，Ninomiya T5，Sugano M6，Yamada H7，Kitajima N8，Yoon S9，Hayashi Y2。
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慢性乙型肝炎（CHB）抗病毒治疗的目的通常是降低HBs抗原（HBsAg）并最终消失。 CHB的干扰素（IFN）治疗似乎在亚洲国家比欧洲国家效果较差，IFN和核苷酸（NA）联合治疗的优势尚未得到充分研究。本研究集中在IFN单药治疗或IFN + NA联合治疗后与HBs抗原相关的因素。本研究共纳入35例接受IFN治疗的CHB患者（平均值±标准差36.7±8.5岁;男性27例，女性8例）。 35例患者中，21例患者接受聚乙二醇化IFN单药治疗，14例接受IFN和阿德福韦联合治疗。我们检查了从初始HBsAg滴度到治疗结束时至治疗结束后24周的HBsAg滴度> 1.0log IU / ml降低的因素。治疗结束时，13例（37％）HBsAg降低> 1.0 IU / ml，7例（20％）治疗后仅维持24周。治疗结束时HBsAg降低的患者HBV核心相关抗原（HBcrAg）滴度显着高于无HBsAg降低的患者（6.56±0.78比5.30±1.66 log IU / ml，P <0.05）。此外，HBsAg减少的患者中丙氨酸氨基转移酶（ALT）增加> 2倍，发生率显着升高（62％vs. 14％，P <0.05）。接受IFN单药治疗的患者HBsAg降低比例高于接受IFN和ADV联合治疗的患者比例（43例，29％，P <0.05）。目前的结果表明，治疗前的HBcr抗原滴度和ALT治疗升高（指示宿主指示闪光）是与基于IFN的治疗后HBsAg滴度降低有关的重要因素。 IFN和ADV联合治疗的疗效在HBsAg滴度的降低方面并不明显。
关键词：

HBcr抗原; HBs抗原;阿德福韦;乙型肝炎病毒;干扰素

结论：
    28819561
PMCID：
    PMC5549598
DOI：
    10.3892 / br.2017.944