AASLD2019[462]后续反应，无核病 聚乙二醇化干扰素代表的良好

StephenW

462
SUSTAINED RESPONSE WITHOUT NUCLEOS(T)IDES AFTER
PEGYLATED INTERFERON REPRESENT FAVORABLE OUTCOME:
UP TO 13years FOLLOW-UP
Soon Kyu Lee, Jung Hyun Kwon, Jeong Won Jang, Hee
Chul Nam, Yoon-Jung Kim, Sun Hong Yoo, Soon Woo
Nam, SI Hyun Bae, Jong Young Choi and Seung Kew Yoon,
Department of Internal Medicine, the Catholic University Liver
Research Center, College of Medicine, the Catholic University
of Korea
Background:: Pegylated interferon (PEG-IFN) treatment with
a high rate of off-therapy immune control is still an attractive
treatment for chronic hepatitis B in the era of nucleos(t)
ides (NAs) There remains uncertain about the prognosis of
sustained responder without NAs after completing PEG-IFN
therapy. We investigated the long-term outcomes of PEGIFN
treatment focused on tolerant patients without NAs up
to 13 years Methods: A consecutive 190 patients treated
with PEG-IFN for chronic hepatitis B or compensated liver
cirrhosis between 2005 and 2014 were enrolled and finally
122 patients who fully completed PEG-IFN treatment were
analyzed The virological response for PEG-IFN treatment
after 6 months of treatment was defined as; HBeAg positive
patients, achieve both virologic response (VR, <2,000 IU/
ml of HBV DNA) and serologic response (HBeAg loss or
seroconversion); HBeAg negative patients achieve VR. We
evaluated the rate of off-therapy HBsAg loss, and the rate
of starting NAs due to viral activation, and development of
liver cirrhosis and hepatocellular carcinoma (HCC) Results:
The median follow-up period of 122 patients were 7 2
years (range, 1 1 -13 2 years) Of 122 patients, 43 patients
(35 2%) showed a response after 6 months of treatment
During follow-up, 69 patients (56 6%) started NAs and the
patients who had a response for PEG-IFN significantly lower
rate of starting NAs (14/43 vs 55/79, P<0 001) HBsAg loss
subsequently occurred in 9 patients (7 4%) and sustained
responders without further NAs treatment had significantly
high rate of HBsAg loss compared to the patients with starting
NAs (13 2% vs 2 9%, P=0 01) All the patients (n=8, 6 6%)
who developed liver cirrhosis and HCC, were non-sustained
responders, in contrast, none of sustained responders
progressed to liver cirrhosis or HCC (P=0 03) Conclusion:
Even though including the patients who were not reached the
response at 6 months after PEG-IFN treatment, sustained
responders without further NAs treatment had a favorable
clinical outcome in HBsAg loss and no disease progression
up to 13 years.

StephenW

462
后续反应，无核病
聚乙二醇化干扰素代表的良好结果：
长达13年的随访
李信圭，郑贤权，郑元章，熙
朱南，金允中，孙洪Hong，吴宇
Nam，SI Hyun Bae，Jong Young Choi和Seung Kew Yoon，
天主教大学肝脏内科
天主教大学医学院研究中心
韩国
背景：聚乙二醇干扰素（PEG-IFN）治疗
高比例的非治疗性免疫控制仍然很有吸引力
核苷时代治疗慢性乙型肝炎（t）
ides（NAs）的预后尚不确定
完成PEG-IFN后无NA的持续应答者
治疗。我们调查了PEGIFN的长期结果
治疗针对无NAs耐受的耐受性患者
至13岁方法：连续治疗190例患者
与PEG-IFN治疗慢性乙型肝炎或代偿性肝
纳入2005年至2014年的肝硬化，最后
完全完成PEG-IFN治疗的122名患者
分析了PEG-IFN治疗的病毒学应答
治疗6个月后的定义为： HBeAg阳性
患者，同时达到病毒学应答（VR，<2,000 IU /
毫升的HBV DNA）和血清反应（HBeAg丢失或
血清转化）； HBeAg阴性患者达到VR。我们
评估了非治疗性HBsAg丢失率以及
病毒激活引起的起始NA的产生以及
肝硬化和肝细胞癌（HCC）结果：
122位患者的中位随访期为7 2
年（范围1 1 -13 2年）122例，43例
（35 2％）治疗6个月后有反应
在随访期间，有69例患者（56 6％）开始了NAs治疗，
对PEG-IFN有反应的患者
起始NA发生率（14/43 vs 55/79，P <0 001）HBsAg丢失
随后发生9例（7 4％），并持续
未经进一步NAs治疗的应答​​者有明显
与开始的患者相比，HBsAg丢失率高
NAs（13 2％vs 2 9％，P = 0 01）所有患者（n = 8，6 6％）
患有肝硬化和肝癌的患者无法维持
相比之下，持续响应者中没有一个
进展为肝硬化或肝癌（P = 0 03）结论：
即使包括未到达的患者
PEG-IFN治疗后6个月持续缓解
未经进一步NAs治疗的应答​​者有良好的反应
HBsAg丢失且无疾病进展的临床结果
长达13年。