乙型肝炎抗原阳性的慢性乙型肝炎患者的粪便菌群移植：一

StephenW

Dig Dis Sci. 2020 Apr 11. doi: 10.1007/s10620-020-06246-x. [Epub ahead of print]
Fecal Microbiota Transplantation in Hepatitis B e Antigen-Positive Chronic Hepatitis B Patients: A Pilot Study.
Chauhan A1, Kumar R2, Sharma S1, Mahanta M1, Vayuuru SK1, Nayak B1, Kumar S1, Shalimar3.
Author information

1
    Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, Room No 127, 1st Floor, New Delhi, 110029, India.
2
    Department of Gastroenterology, All India Institute of Medical Sciences, Patna, India.
3
    Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, Room No 127, 1st Floor, New Delhi, 110029, India. [email protected].

Abstract
BACKGROUND:

Intestinal flora plays a critical role in immunity against hepatitis B virus (HBV). Fecal Microbiota Transplantation (FMT) may be a potential immunomodulatory therapy in patients with chronic hepatitis B (CHB).
AIM:

We aimed to study role of FMT in hepatitis B e antigen (HBeAg)-positive CHB patients in terms of its effect on HBeAg, HBsAg, and HBV DNA.
METHODS:

HBeAg-positive patients despite being on antiviral treatment for > 1 year were given six cycles of FMT via gastroscope (nasoduodenal route) at 4 weekly intervals along with antiviral therapy. Twelve out of 14 included patients in FMT arm completed six cycles. Another 15 HBeAg-positive patients who were on oral antivirals for > 1 year were taken as control-antiviral therapy (AVT) arm. Per-protocol analysis was done.
RESULTS:

The median (interquartile range) age in the FMT and AVT arm were 29 (25-35) and 29(24-38), respectively (P = 0.794). The median (interquartile range) duration of AVT prior to inclusion in the study was 80 (52-104) and 76 (52-114) months in FMT and AVT arm, respectively (P = 0.884). In the FMT arm, 16.7% (2/12) patients had HBeAg clearance in comparison to none in the AVT arm (P = 0.188). None of the patients in either arm had HBsAg loss. The FMT was tolerated well, 42.8% (6/14) patients reported one or more minor adverse events.
CONCLUSIONS:

In this non-randomized pilot study, FMT appears to be safe and potentially effective in terms of viral suppression and HBeAg clearance in patients with HBeAg-positive CHB. Further randomized controlled trials are needed in order to obtain robust conclusions.
KEYWORDS:

Bacteria; Dysbiosis; Fungi; Microbiome; Virus

PMID:
    32279172
DOI:
    10.1007/s10620-020-06246-x

StephenW

Dig Dis Sci。 2020年4月11日。doi：10.1007 / s10620-020-06246-x。 [Epub提前发行]
乙型肝炎抗原阳性的慢性乙型肝炎患者的粪便菌群移植：一项初步研究。
Chauhan A1，Kumar R2，Sharma S1，Mahanta M1，Vayuuru SK1，Nayak B1，Kumar S1，Shalimar3。
作者信息

1个
    全印度医学科学研究所胃肠病学和人类营养系，印度新德里110029一楼127室。
2
    印度巴特那全印度医学科学研究所消化内科。
3
    全印度医学科学研究所胃肠病学和人类营养系，印度新德里110029一楼127室。 [email protected]。

抽象
背景：

肠道菌群在抵抗乙型肝炎病毒（HBV）的免疫中起关键作用。粪便微生物菌群移植（FMT）可能是慢性乙型肝炎（CHB）患者的一种潜在的免疫调节疗法。
目标：

我们旨在研究FMT在乙型肝炎e抗原（HBeAg）阳性CHB患者中的作用，根据其对HBeAg，HBsAg和HBV DNA的影响。
方法：

尽管接受抗病毒治疗超过1年的HBeAg阳性患者通过胃镜（鼻十二指肠途径）每隔4周接受FMT六个周期的治疗，同时进行抗病毒治疗。 FMT组的14名患者中有12名完成了6个周期。接受口服抗病毒药物治疗≥1年的15例HBeAg阳性患者被作为对照抗病毒治疗（AVT）组。按协议进行分析。
结果：

FMT和AVT组的中位年龄（四分位间距）分别为29岁（25-35岁）和29岁（24-38岁）（P = 0.794）。在纳入研究之前，在FMT和AVT组中，AVT的中位（四分位间距）持续时间分别为80（52-104）和76（52-114）个月（P = 0.884）。在FMT组中，有16.7％（2/12）的患者具有HBeAg清除率，而在AVT组中则没有（P = 0.188）。两组患者均无HBsAg丢失。 FMT的耐受性良好，有42.8％（6/14）的患者报告了一种或多种轻微不良事件。
结论：

在这项非随机的先导研究中，就HBeAg阳性CHB患者的病毒抑制和HBeAg清除率而言，FMT似乎是安全且潜在有效的。为了获得可靠的结论，还需要进一步的随机对照试验。
关键字：

菌;营养不良;菌类;微生物组；病毒

PMID：
    32279172
DOI：
    10.1007 / s10620-020-06246-x

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