聚乙二醇干扰素α附加治疗对长期核苷（酸）类似

StephenW

J Viral Hepat. 2019 Jul;26 Suppl 1:50-58. doi: 10.1111/jvh.13152.
Histological responses of peginterferon alpha add-on therapy in patients with chronic hepatitis B with advanced liver fibrosis after long-term nucleos(t)ide analog treatment.
Li G1, Zhang Q2, Yu Y2, Qiu C2,3, Zhang H2, Zhang M2, Song Z4, Yang Y4, Hong J5, Lu J5, Li N5, Tang Q5, Xu L5, Wang X3, Zhang W2,3, Chen Z1.
Author information
Abstract

Although long-term antiviral treatment with nucleos(t)ide analogs (NAs) can lead to histological improvement in patients with chronic hepatitis B (CHB), a substantial proportion of patients still fail to achieve regression of fibrosis. Here, we investigated whether peginterferon alpha (Peg-IFNα） add-on therapy had benefits on fibrosis regression in patients with sustained severe fibrosis even after long-term NA treatment. We conducted a retrospective analysis of data from 50 patients with CHB receiving 48 weeks of Peg-IFNα add-on therapy. All enrolled patients had advanced fibrosis or cirrhosis (S score ≥ 3) at baseline and underwent NA treatment for at least 1 year before Peg-IFNα addition. Paired liver biopsies before and after Peg-IFNα add-on treatment and laboratory tests at baseline, 24 weeks of treatment, 48 weeks of treatment and long-term follow-up were analysed. Of the 50 patients enrolled in this study, 34 patients (68.0%) had significant regression of fibrosis, and 42 (84.0%) showed significant remission of inflammation after Peg-IFNα add-on treatment. Compared with nonresponders, patients with significant histological improvement showed faster hepatitis B surface antigen (HBsAg) decline and tended to have higher cumulative hepatitis B e antigen (HBeAg) and HBsAg loss rates during long-term follow-up. Peg-IFNα add-on therapy led to significant regression of fibrosis and resolution of inflammation in patients with advanced fibrosis after long-term NA treatment.

© 2019 The Authors. Journal of Viral Hepatitis Published by John Wiley & Sons Ltd.
KEYWORDS:

chronic hepatitis B; histopathology; nucleos(t)ide analog; peginterferon alpha

PMID:
    31380590
DOI:
    10.1111/jvh.13152

StephenW

J病毒肝病。 2019年7月; 26增刊1：50-58。 doi：10.1111 / jvh.13152。
聚乙二醇干扰素α附加治疗对长期核苷（酸）类似物治疗后慢性乙型肝炎晚期肝纤维化患者的组织学反应。
Li G1，Zhang Q2，Yu Y2，Qiu C2,3，Zhang H2，Zhang M2，Song Z4，Yang Y4，Hong J5，Lu J5，Li N5，Tang Q5，Xu L5，Wang X3，Zhang W2,3，Chen Z1。
作者信息
抽象

尽管使用核苷（酸）类似物（NAs）的长期抗病毒治疗可以导致慢性乙型肝炎（CHB）患者的组织学改善，但是相当大比例的患者仍未能实现纤维化的消退。在这里，我们研究了聚乙二醇干扰素α（Peg-IFNα）添加疗法是否对持续严重纤维化患者的纤维化消退有益，即使在长期NA治疗后也是如此。我们对50例接受48周CHB治疗的患者进行了回顾性分析。 Peg-IFNα附加疗法。所有入组患者在基线时均有晚期纤维化或肝硬化（S评分≥3），并且在Peg-IFNα加入前进行NA治疗至少1年.Peg-IFNα加入前后的成对肝脏活组织检查 - 在基线治疗和实验室检查，治疗24周，治疗48周和长期随访中进行分析。在本研究纳入的50名患者中，34名患者（68.0％）有明显的纤维化消退， Peg-IFNα加入治疗后，42例（84.0％）显示炎症明显缓解。与无应答者相比，组织学改善显着的患者乙型肝炎表面抗原（HBsAg）下降速度加快d在长期随访期间有较高的累积乙型肝炎e抗原（HBeAg）和HBsAg丢失率。 Peg-IFNα附加疗法导致长期NA治疗后晚期纤维化患者纤维化和炎症消退的显着消退。

©2019作者。病毒性肝炎杂志由John Wiley＆Sons Ltd.出版
关键词：

慢性乙型肝炎;组织病理学;核苷（酸）类似物;聚乙二醇干扰素α

结论：
    31380590
DOI：
    10.1111 / jvh.13152

rxsm

晚期纤维化也能使用干扰素？

齐欢畅

StephenW

回复 rxsm 的帖子

需要加上NA治疗 (NA治疗至少一年). 这可以防止ALT升高如果单干扰素治疗?