干扰素α治疗导致中国慢性乙型肝炎患儿乙型肝炎表面抗原

StephenW

J Viral Hepat. 2019 Jul;26 Suppl 1:77-84. doi: 10.1111/jvh.13165.
Interferon alpha treatment leads to a high rate of hepatitis B surface antigen seroconversion in Chinese children with chronic hepatitis B.
Fan H1, Lin L1, Jia S1, Xie M1, Luo C1, Tan X1, Ying R1, Guan Y1, Li F1.
Author information

1
    Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.

Abstract

Chronic hepatitis B virus (HBV) infection (CHB) in children remains a public health challenge despite significant success in programme is established to prevent mother-to-child transmission. In particular, CHB in Chinese children are mostly acquired through vertical transmission, which differs from the common infection route reported in other countries and regions. This situation has resulted in a high endemic prevalence of CHB in Chinese adults. Thus, successful treatment of children with CHB will prevent the development of advanced liver diseases in late adulthood. However, there is still no consensus on the clinical guideline to treat paediatric CHB. In this study, we evaluated the potential of interferon alpha (IFNa) treatment for Chinese children with CHB. A total of 41 patients with CHB aged 3-17 years were enrolled in this retrospective study: 21 patients were treated with pegylated (PEG)-IFNa and 20 patients without treatment served as the control group. The rates of HBV DNA suppression, hepatitis B e antigen (HBeAg) clearance and hepatitis B surface antigen (HBsAg) clearance were significantly higher in the PEG-IFNa treatment group than in the control group (P < 0.05 at 48 weeks). Unexpectedly, PEG-IFNa treatment achieved a high rate of HBsAb production, far exceeding the clinical outcome in documented PEG-IFNa-treated CHB adults. Further analysis revealed that younger children (3-6 years old) were more responsive to PEG-IFNa treatment with respect to achieving a protective level of HBsAb in a short treatment cycle than adolescents (10-17 years old). Overall, these results indicate that the immune system of children might have a preserved PEG-IFNa-mediated mechanism to completely control HBV, which can help to design new strategies to treat CHB patients.

© 2019 John Wiley & Sons Ltd.
KEYWORDS:

HBsAb; HBsAg seroconversion; IFNa; hepatitis B virus; paediatric chronic hepatitis

PMID:
    31380586
DOI:
    10.1111/jvh.13165

StephenW

J病毒肝病。 2019年7月; 26增刊1：77-84。 doi：10.1111 / jvh.13165。
干扰素α治疗导致中国慢性乙型肝炎患儿乙型肝炎表面抗原血清学转换率高。
范H1，林L1，贾S1，谢M1，罗C1，谭X1，莹R1，关Y1，李F1。
作者信息

1
    广州医科大学广州市第八人民医院，广州，中国。

抽象

儿童慢性乙型肝炎病毒（HBV）感染（CHB）仍然是一项公共卫生挑战，尽管已制定了防止母婴传播方案的重大成功。特别是中国儿童的CHB多数是通过垂直传播获得的，这与其他国家和地区报道的常见感染途径不同。这种情况导致中国成年人CHB流行率高。因此，成功治疗CHB患儿可以预防成年后期晚期肝病的发展。然而，对于治疗儿科CHB的临床指南仍未达成共识。在这项研究中，我们评估了干扰素α（IFNa）治疗中国儿童CHB的可能性。本回顾性研究共纳入41例3~17岁CHB患者：21例患者接受聚乙二醇化（PEG）-IFNa治疗，20例未接受治疗的患者作为对照组。 PEG-IFNa治疗组的HBV DNA抑制率，乙型肝炎e抗原（HBeAg）清除率和乙型肝炎表面抗原（HBsAg）清除率显着高于对照组（48周时P <0.05）。出乎意料的是，PEG-IFNa治疗实现了高HBsAb产生率，远远超过了记录的PEG-IFNa治疗的CHB成人的临床结果。进一步的分析显示，年龄较小的儿童（3-6岁）对PEG-IFNa治疗的反应更快，在短期治疗周期内达到HBsAb的保护水平，而不是青少年（10-17岁）。总体而言，这些结果表明儿童的免疫系统可能具有保留的PEG-IFNa介导的完全控制HBV的机制，这可以帮助设计治疗CHB患者的新策略。

©2019 John Wiley＆Sons Ltd.
关键词：

乙肝表面抗体; HBsAg血清学转换; α-干扰素;乙型肝炎病毒;小儿慢性肝炎

结论：
    31380586
DOI：
    10.1111 / jvh.13165