恩替卡韦和聚乙二醇干扰素联合治疗慢性乙型肝炎后肝炎表

StephenW

Antivir Ther. 2018 Feb 13. doi: 10.3851/IMP3225. [Epub ahead of print]
Sustained antiviral effects and clearance of hepatitis surface antigen after combination therapy with entecavir and pegylated interferon in chronic hepatitis B.Hagiwara S1, Nishida N1, Watanabe T1, Ida H1, Sakurai T1, Ueshima K1, Takita M1, Komeda Y1, Nishijima N2, Osaki Y2, Kudo M1.
Author information
1Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan.2Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan.

AbstractBACKGROUND: Although the efficacy of combination therapy with lamivudine or tenofovir and pegylated-interferon (Peg-IFN) has been reported in patients with chronic hepatitis B (CHB), the long-term effect of the combination based on the observation of clinical course remains to be clarified. We previously reported the efficacy of combination therapy with entecavir (ETV) and Peg-IFN. Here, we investigated the long-term effect of this combination in patients with CHB.
METHODS: We administered both ETV and Peg-IFN α-2a or -2b simultaneously to 26 patients with hepatitis B virus genotype C infection. Treatment was continued for 48 weeks followed by 24 weeks of observation period; we examined the virological and biochemical responses. We also analyzed characteristics related to the post-treatment relapse. Finally, we investigated the long-term therapeutic effects.
RESULTS: Average reduction of intra-hepatic cccDNA level was 1.2-log copies/μg at the completion of administration. Pretreatment hepatitis B surface antigen (HBsAg) level with more than 3.5 log U/mL was identified as a predictive factor for relapse. Furthermore, the cumulative rates of HBsAg-negative patients at 1, 3, and 5 years after the completion of administration were 3.8, 8.4, and 15%, respectively (mean follow-up period: 4.8 years).
CONCLUSIONS: Baseline HBsAg level with more than 3.5 log U/mL is a useful predictor for relapse 24 weeks after the completion of administration in patients treated with combination therapy. Combination with ETV and Peg-IFN could be an option for treatment of CHB patients especially in those with baseline HBs Ag levels of less than 3.5 log U/mL.


PMID:29438098DOI:10.3851/IMP3225

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StephenW

Antivir Ther。 2018年2月13日，doi：10.3851 / IMP3225。 [电子版提前打印]
恩替卡韦和聚乙二醇干扰素联合治疗慢性乙型肝炎后肝炎表面抗原的持续抗病毒作用和清除率
Hagiwara S1，Nishida N1，Watanabe T1，Ida H1，Sakurai T1，Ueshima K1，Takita M1，Komeda Y1，Nishijima N2，Osaki Y2，工藤M1。
作者信息

1
    Kindai大学医学部胃肠病学系，日本大阪佐山市。
2
    日本大阪大阪红十字会医院消化科和肝病科。

抽象
背景：

尽管在慢性乙型肝炎（CHB）患者中已经报道了拉米夫定或替诺福韦和聚乙二醇干扰素（Peg-IFN）联合治疗的疗效，但基于观察临床过程的联合疗法的长期疗效仍有待提高澄清。我们以前报道恩替卡韦（ETV）和Peg-IFN联合治疗的疗效。在这里，我们调查了这种组合对慢性乙型肝炎患者的长期影响。
方法：

我们同时对26名乙型肝炎病毒基因型C感染患者同时施用ETV和Peg-IFNα-2a或-2b。继续治疗48周，然后观察24周;我们检查了病毒学和生物化学反应。我们还分析了与治疗后复发相关的特征。最后，我们调查了长期的治疗效果。
结果：

在给药完成时，肝内cccDNA水平的平均降低为1.2-log拷贝/μg。预处理乙型肝炎表面抗原（HBsAg）水平超过3.5 log U / mL被确定为复发的预测因素。此外，HBsAg阴性患者在给药完成后1年，3年和5年累计发生率分别为3.8％，8.4％和15％（平均随访时间为4.8年）。
结论：

超过3.5log 10 U / mL的基线HBsAg水平是联合治疗患者给药完成后24周复发的有用预测指标。与ETV和Peg-IFN联合使用可以成为治疗慢性乙型肝炎患者的一种选择，特别是基线HBsAg水平低于3.5log U / mL的患者。

结论：
    29438098
DOI：
    10.3851 / IMP3225