从头开始联合抗病毒治疗在e抗原阴性的慢性乙肝病毒感染的

StephenW

De novo combination antiviral therapy in e antigen-negative chronic hepatitis B virus-infected pediatric patients with advanced fibrosis
Yi Dong  1 , Meina Li  2 , Shishu Zhu  1 , Xue Gao  1 , Pan Zhao  1
Affiliations
Affiliations

    1
    The Fifth Medical Center (formerly Beijing 302 Hospital), Chinese PLA General Hospital, Beijing, 100039, China.
    2
    Department of Health Service, Second Military Medical University, Shanghai, 200433, China.

    PMID: 32810891 DOI: 10.1111/jvh.13372

Abstract

To date, studies that focus on treatment of e antigen-negative chronic hepatitis B virus-infected children with advanced fibrosis are extremely limited. This puts these patients at risk of rapid disease progression. Our study aimed to investigate the efficacy of combination antiviral therapy in this population. We prospectively enrolled treatment-naı̈ve pediatric patients between 1 year and 12 years of age who had e antigen-negative chronic hepatitis B and histologically proven advanced fibrosis. All patients received de novo combination therapy with lamivudine (LAM) and interferon-α (IFN) for 12 months and then were clinically followed-up. The main outcome measure was rate of serum hepatitis B surface antigen (HBsAg) loss at month 12 of treatment. A total of 14 pediatric patients were enrolled, including 9 boys and 5 girls. All patients achieved undetectable HBV DNA levels at month 9 of treatment. A total of 5 patients (35.7%) achieved HBsAg loss at month 12 and finally developed HBsAg seroconversion. Four patients who did not clear HBsAg underwent second liver biopsy and histological evaluation revealed significant improvements in all of them. As a serum fibrosis marker, aspartate aminotransferase to platelet ratio index after 12-month treatment in the 14 patients showed a significant improvement compared with that at baseline (P=0.0021). No serious adverse events were observed during the study. Combination antiviral therapy is beneficial to e antigen-negative chronic hepatitis B virus-infected pediatric patients with advanced fibrosis. Further studies with larger cohorts are required.

Keywords: HBeAg negativity; children; fibrosis; hepatitis B virus.

StephenW

从头开始联合抗病毒治疗在e抗原阴性的慢性乙肝病毒感染的小儿晚期纤维化患者中
易栋1，李美娜2，朱世书1，学高1，潘昭1
隶属关系
隶属关系

    1个
    中国人民解放军总医院第五医疗中心（原北京302医院），北京100039。
    2
    第二军医大学卫生服务系，上海200433。

    PMID：32810891 DOI：10.1111 / jvh.13372

抽象

迄今为止，专注于治疗晚期肝纤维化的e抗原阴性慢性乙型肝炎病毒感染儿童的研究极为有限。这使这些患者处于疾病快速发展的风险中。我们的研究旨在调查在该人群中联合抗病毒治疗的疗效。我们前瞻性地招募了1至12岁的初治儿科患者，这些患者患有e抗原阴性的慢性乙型肝炎，并经组织学证实为晚期纤维化。所有患者均接受拉米夫定（LAM）和干扰素-α（IFN）的从头联合治疗，为期12个月，然后进行临床随访。主要结局指标是治疗第12个月时血清乙型肝炎表面抗原（HBsAg）的流失率。总共招募了14名儿科患者，包括9名男孩和5名女孩。所有患者在治疗的第9个月都达到了无法检测到的HBV DNA水平。共有5例患者（35.7％）在第12个月达到HBsAg丢失，并最终出现HBsAg血清转化。 4例未清除HBsAg的患者进行了第二次肝活检，组织学评估显示所有患者均明显改善。作为血清纤维化标志物，与基线时相比，在14例患者中治疗12个月后的天冬氨酸转氨酶与血小板比率指数显着改善（P = 0.0021）。在研究过程中未观察到严重的不良事件。联合抗病毒治疗对e抗原阴性的慢性乙肝病毒感染的小儿晚期纤维化患者有益。需要对更大的人群进行进一步研究。

关键字：HBeAg阴性；孩子们纤维化乙型肝炎病毒。