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

Infect Drug Resist. 2018 Oct 29;11:2001-2009. doi: 10.2147/IDR.S175707. eCollection 2018.
Entecavir add-on or switch-to pegylated interferon improves HBsAg clearance in HBe antigen negative chronic hepatitis B patients.
Yan L1, Zhu C2, Li J3, Chen L1, Ding Y1, Cao Z1, Liu K1,4, Lin L1, Tang W1, Xie Q1, Xu Y1, Bao S5, Wang H1.
Author information

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

Abstract
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:

HBsAg; PEG-IFN; add-on; chronic hepatitis B; entecavir; switch-to

PMID:
    30464542
PMCID:
    PMC6211310
DOI:
    10.2147/IDR.S175707

StephenW

感染药物抵抗。 2018年10月29日; 11：2001-2009。 doi：10.2147 / IDR.S175707。 eCollection 2018。
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。
Yan L1，Zhu C2，Li J3，Chen L1，Ding Y1，Cao Z1，Liu K1,4，Lin L1，Tang W1，​​Xie Q1，Xu Y1，Bao S5，Wang H1。
作者信息

1
    上海交通大学医学院附属瑞金医院感染科，上海200025，wanghuirj @ 163.com。
2
    苏州市第五人民医院感染科，江苏苏州215007
3
    淮安市第四人民医院感染科，江苏223002
4
    上海交通大学医学院附属瑞金医院感染科，上海201801
五
    澳大利亚新南威尔士州悉尼悉尼大学查尔斯珀金中心医学科学与博世学院病理学学科[email protected]。

抽象
背景和目的：

慢性乙型肝炎（CHB）患者很少通过核苷/核苷酸类似物治疗获得乙型肝炎表面抗原（HBsAg）损失。
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on（n = 26）聚乙二醇化干扰素（PEG-IFN）和持续的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周时HBsAg的减少分别为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：

乙肝表面抗原; PEG-IFN;添加在;慢性乙型肝炎;恩替卡韦;切换到

结论：
    30464542
PMCID：
    PMC6211310
DOI：
    10.2147 / IDR.S175707

StephenW

https://www.dovepress.com/enteca ... eviewed-article-IDR