恩替卡韦添加或转换为聚乙二醇化干扰素可改善HBe抗原阴性

StephenW

Entecavir add-on or switch-to pegylated interferon improves HBsAg clearance in HBe antigen negative chronic hepatitis B patients
         

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Authors Yan L, Zhu C, Li J, Chen L, Ding Y, Cao Z, Liu K, Lin L, Tang W, Xie Q, Xu Y, Bao S, Wang H

Received 29 May 2018

Accepted for publication 15 August 2018

Published 29 October 2018 Volume 2018:11 Pages 2001—2009

DOI https://doi.org/10.2147/IDR.S175707

Checked for plagiarism Yes

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Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 5

Editor who approved publication: Professor Suresh Antony

Lei Yan,1,* Chuanwu Zhu,2,* Jing Li,3,* Liwen Chen,1 Yezhou Ding,1 Zhujun Cao,1 Kehui Liu,1,4 Lanyi Lin,1 Weiliang Tang,1 Qing Xie,1 Yumin Xu,1 Shisan Bao,5 Hui Wang1

1Department of Infectious Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; 2Department of Infectious Diseases, The Fifth People’s Hospital of Suzhou, Jiangsu 215007, China; 3Department of Infectious Diseases, Huai-An Fourth People’s Hospital, Jiangsu 223002, China; 4Department of Infectious Diseases, Rui Jin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai 201801, China; 5Discipline of Pathology, School of Medical Sciences and Bosch Institute, Charles Perkin Centre, University of Sydney, Sydney, NSW, Australia

*These authors contributed equally to this work

Background and aims: Chronic hepatitis B (CHB) patients rarely achieve hepatitis B surface antigen (HBsAg) loss with nucleoside/nucleotide analog therapy.
Methods: In this retrospective study, it was evaluated that the rate of HBsAg loss in the HBe antigen negative (HBeAg−) patients (n=101) treated with entecavir (ETV) for ≥24 weeks followed by switching to (n=22) or adding on (n=26) pegylated interferon (PEG-IFN), and continuing ETV (n=53).
Results: HBsAg clearance rate at week 48 was 9% (2/22), 15% (4/26), and 0% (0/53) (P<0.05), in switch-to or add-on, or ETV monotherapy CHB patients, respectively. HBsAg reduction at week 48 was 1.182, 0.6614, or 0.056 log IU/mL, in switch-to, add-on, and ETV patients, respectively (P<0.001). The response rate (HBsAg reduction >1 log IU/mL at week 48) in the switch-to, add-on, and ETV monotherapy CHB patients was 60%, 40%, and 2%, respectively (P<0.001). In the switch-to and add-on patients, HBsAg reduction and clearance were associated with HBsAg titers at week 0 and HBsAg reduction at week 24. Furthermore, HBsAg reduction at week 24 was associated with the response rate at week 48 in the switch-to and add-on patients, showing that the area under the receiver operating characteristic curve was 0.904. Positive predictive value and negative predictive value for response rate was 70% and 100% with cut-off value 0.2 log IU/mL, respectively.
Conclusion: In summary, we demonstrated that PEG-IFN enhanced HBsAg loss in HBeAg− CHB patients. High HBsAg clearance was achieved in the patients with HBsAg titers at baseline <1,000 IU/mL and HBsAg reduction >0.2 log IU/mL.

Keywords: chronic hepatitis B, HBsAg, PEG-IFN, entecavir, switch-to, add-on

StephenW

恩替卡韦添加或转换为聚乙二醇化干扰素可改善HBe抗原阴性慢性乙型肝炎患者的HBsAg清除率
         

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作者严莉，朱C，李杰，陈莉，丁,,曹,,刘克，林莉，唐伟，谢琦，徐,,包思，王鹤

2018年5月29日收到

接受发布于2018年8月15日

2018年10月29日出版卷2018：11页2001-2009

DOI https://doi.org/10.2147/IDR.S175707

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Amy Norman博士批准的同行评审员

同行评审员评论5

批准出版的编辑：Suresh Antony教授

雷燕，1，*朱传武，2，*李静，3，*李文文，1 Yezhou Ding，1 Zhujun Cao，1 Kehui Liu，1,4 Lanyi Lin，1 Weiliang Tang，1 Qing Xie，1 Yumin Xu ，1十三宝，5惠王1

1上海交通大学医学院附属瑞金医院感染科，上海200025; 2苏州市第五人民医院感染科，江苏苏州215007;淮安市第四人民医院感染科，江苏223002;上海交通大学医学院附属瑞金医院北区4感染科，上海201801; 5澳大利亚新南威尔士州悉尼悉尼大学Charles Perkin中心医学科学与博世研究所病理学学科

*这些作者同等贡献这项工作

背景和目的：慢性乙型肝炎（CHB）患者很少通过核苷/核苷酸类似物治疗实现乙型肝炎表面抗原（HBsAg）的丧失。
方法：在这项回顾性研究中，评估了恩替卡韦（ETV）治疗≥24周的HBe抗原阴性（HBeAg-）患者（n = 101）HBsAg消失率随后转为（n = 22）或加入（n = 26）聚乙二醇化干扰素（PEG-IFN）和持续ETV（n = 53）。
结果：第48周的HBsAg清除率为9％（2/22），15％（4/26）和0％（0/53）（P <0.05），转换为或附加或ETV单药治疗CHB患者，分别。第48周的HBsAg降低分别为1.182,0.6614或0.056 log IU / mL，分别为交换型，附加型和ETV型患者（P <0.001）。转换为，附加组和ETV单一疗法CHB患者的应答率（HBsAg降低> 1 log IU / mL，第48周）分别为60％，40％和2％（P <0.001）。在转换和接种患者中，HBsAg降低和清除与第0周的HBsAg滴度和第24周的HBsAg降低相关。此外，第24周的HBsAg降低与转换时第48周的应答率相关 - 对患者和附加患者，显示接受者操作特征曲线下面积为0.904。响应率的阳性预测值和阴性预测值分别为70％和100％，临界值为0.2 log IU / mL。
结论：总之，我们证明PEG-IFN增强了HBeAg-CHB患者的HBsAg消失。 HBsAg滴度在基线<1,000 IU / mL且HBsAg降低> 0.2 log IU / mL的患者中达到高HBsAg清除率。

关键词：慢性乙型肝炎，HBsAg，PEG-IFN，恩替卡韦，转换为，附加

StephenW

https://www.dovepress.com/getfile.php?fileID=45707