[基线丙氨酸氨基转移酶水平与慢性乙型肝炎患者恩替卡韦和

StephenW

Nan Fang Yi Ke Da Xue Xue Bao. 2019 Feb 28;39(2):150-155. doi: 10.12122/j.issn.1673-4254.2019.09.04.
[Association of baseline alanine aminotransferase levels with therapeutic effects of entecavir and interferon-α in patients with chronic hepatitis B].
[Article in Chinese]
Xiao Z1, Zhou F1, Zhou B1, Yang J1.
Author information

1
    State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.

Abstract
OBJECTIVE:

To evaluate the therapeutic effects of entecavir (ETV) and interferon-α (IFN-α) treatments for 48 weeks for chronic hepatitis B (CHB) in patients with different baseline alanine aminotransferase (ALT) levels.
METHODS:

We retrospectively analyzed the data of 369 CHB patients receiving ETV and IFN-α treatments for 48 weeks. We compared the virological response rates, HBsAg clearance, and HBsAg reduction between the patients receiving ETV and IFN-α treatments with different baseline ALT levels[≤ 5×upper limits of normal (ULN) level (subgroup 1), 5-10×ULN (subgroup 2), and > 10× ULN (subgroup 3)].
RESULTS:

In patients receiving ETV treatment, the virological response rate was 83.3% in subgroup 1, 91.4% in subgroup 2, and 95.5% in subgroup 3, as compared with 19.7%, 40%, and 42.9% in the 3 subgroups with IFN-α treatment, respectively, showing significantly differences both among different subgroups with the same treatment and between the same subgroup with different treatments (P < 0.05). HBeAg clearance rates in the 3 subgroups were 8.3%, 16.7% and 35.5% in patients with ETV treatment and were 1.8%, 41.9%, and 38.1% in patients with IFN-α treatment, respectively, showing significant differences among the 3 subgroups with the same treatment (P < 0.05); in the same subgroups with different treatments, the rates differed significantly only between subgroups 2 (P < 0.05). In ETV group, the rate of HBsAg reduction to below 200 IU/ml was 2.5% in subgroup 1 and 13.8% in subgroup 2, showing no significant difference between the two subgroups; in IFN-α group, the rates were also similar between subgroups 1 and 2 (30.6% vs 33.3%, P > 0.05); but the rates differed significantly between the same subgroups with different treatments (P < 0.05).
CONCLUSIONS:

In all the subgroups with different baseline ALT levels, ETV treatment for 48 weeks results in significantly higher virological response rates than IFN-α treatment in patients with CHB. In patients with a baseline ALT of 5-10 ×ULN, IFN-α can result in a higher HBeAg clearance rate than ETV. In patients with comparable baseline ALT level, IFN-α more effectively reduces HBsAg level than ETV. The patients with a relatively high baseline ALT level (> 5 × ULN) show better responses to both ETV and IFN-α treatment than those with ALT level below 5×ULN. We thus recommend IFN-α for patients with a baseline ALT of 5-10×ULN and ETV for patients with a baseline ALT either below 5 × ULN or beyond 10×ULN.
KEYWORDS:

alanine aminotransferase; chronic hepatitis B; entecavir; interferon-α

PMID:
    30890501
DOI:
    10.12122/j.issn.1673-4254.2019.09.04

StephenW

南方一科大学学报。 2019年2月28日; 39（2）：150-155。 doi：10.12122 / j.issn.1673-4254.2019.09.04。
[基线丙氨酸氨基转移酶水平与慢性乙型肝炎患者恩替卡韦和干扰素-α治疗效果的关系]。
[中文]
小Z1，周F1，周B1，杨J1。
作者信息

1
南方医科大学南方医院传染病科，广东省病毒性肝炎重点实验室器官衰竭研究国家重点实验室，广州510515

抽象
目的：

评估恩替卡韦（ETV）和干扰素-α（IFN-α）治疗48周对慢性乙型肝炎（CHB）治疗不同基线丙氨酸氨基转移酶（ALT）水平的疗效。
方法：

我们回顾性分析了接受ETV和IFN-α治疗48周的369名CHB患者的数据。我们比较接受ETV和IFN-α治疗的患者的病毒学应答率，HBsAg清除率和HBsAg降低与不同的基线ALT水平[≤5×正常上限（ULN）水平（亚组1），5-10×ULN （子组2），＆gt; 10×ULN（第3组）]。
结果：

在接受ETV治疗的患者中，亚组1的病毒学应答率为83.3％，亚组2为91.4％，亚组3为95.5％，而IFN-α的3个亚组为19.7％，40％和42.9％。治疗分别显示具有相同治疗的不同亚组和具有不同治疗的相同亚组之间的显着差异（P <0.05）。 ETV治疗组患者的3个亚组的HBeAg清除率分别为8.3％，16.7％和35.5％，IFN-α治疗组的HBeAg清除率分别为1.8％，41.9％和38.1％，显示3个亚组之间的显着差异。相同的治疗（P <0.05）;在不同治疗的相同亚组中，不同亚组2之间的比率差异显着（P <0.05）。在ETV组，HBsAg降至200 IU / ml以下的比率在第1组为2.5％，在第2组为13.8％，两组之间没有显着差异;在IFN-α组中，亚组1和2之间的比率也相似（30.6％对比33.3％，P> 0.05）;但是不同处理的相同亚组之间的比率差异显着（P <0.05）。
结论：

在具有不同基线ALT水平的所有亚组中，对于CHB患者，ETV治疗48周导致比IFN-α治疗显着更高的病毒学应答率。在基线ALT为5-10×ULN的患者中，IFN-α可导致比ETV更高的HBeAg清除率。在具有可比基线ALT水平的患者中，IFN-α比ETV更有效地降低HBsAg水平。具有相对高的基线ALT水平（> 5×ULN）的患者对ETV和IFN-α治疗的反应比ALT水平低于5×ULN的患者更好。因此，对于基线ALT低于5×ULN或超过10×ULN的患者，我们推荐基线ALT为5-10×ULN和ETV的患者使用IFN-α。
关键词：

丙氨酸氨基转移酶;慢性乙型肝炎;恩替卡韦;干扰素α

结论：
30890501
DOI：
10.12122 / j.issn.1673-4254.2019.09.04