干扰素-α治疗HBeAg阳性慢性乙型肝炎病毒感染的超长期随访

StephenW

Ultra long-term follow-up of interferon-alpha treatment for HBeAg-positive chronic hepatitis B virus infection

    Hannah S.J. Choi
    Margo J.H. van Campenhout
    Anneke J. van Vuuren
    Robert J. de Knegt
    Bettina E. Hansen
    Harry L.A. Janssen
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Published:September 02, 2020DOI:https://doi.org/10.1016/j.cgh.2020.09.004

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Abstract
Background and Aims
Interferon-alpha (IFN-α) treatment for chronic hepatitis B (CHB) virus infection is finite and leads to relatively higher functional cure rates (HBsAg loss) than nucleo(s)tide analogue (NA) therapy. Effects of pegylated (PEG)/conventional IFN-α treatment on clinical outcomes were evaluated in an ultra long-term follow-up of CHB patients.
Methods
HBeAg-positive patients treated with (PEG)IFN-α at a tertiary referral centre between 1977-2014 were included. We reviewed medical charts and consulted the municipal registry for patient information. Patients were invited for a single visit at the outpatient clinic in the case of missing follow-up data. The endpoints included serum HBeAg/HBsAg loss and incidence of clinical events, using life table methods and person-years to analyze the incidence of events. Patients were censored upon retreatment.
Results
The study cohort included 267 patients, 67% male, 58% Caucasian, with a median age of 32 years. The median follow-up duration was 11.5 years. The 5 and 10-year cumulative incidence of HBsAg loss were 14% and 32%, respectively. Baseline factors associated with a higher rate of HBsAg loss were male sex, Caucasian race, genotype A, age ≥40 years, and cirrhosis. HBsAg loss rates did not differ significantly between those who received short-term (≤24 weeks) versus long-term (>24 weeks) therapy. Both HBeAg and HBsAg loss were significantly associated with improved clinical outcomes. Early response (HBeAg loss) was associated with more HBsAg loss and better patient outcomes.
Conclusions
During long-term follow-up, high rates of HBsAg loss were observed from a single (PEG)IFN-α course. Its persistent effects suggest that a role for IFN-α remains, potentially in novel combination therapies in search of a functional cure.
Keywords

    viral hepatitis
    immunomodulator
    long-term outcomes
    prognosis

StephenW

干扰素-α治疗HBeAg阳性慢性乙型肝炎病毒感染的超长期随访

    汉娜·S·J。崔
    玛戈·J·H范坎彭豪特
    安妮克·范·伏伦
    罗伯特·德·克内格特
    贝蒂娜·汉森
    哈里·詹森
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发布时间：2020年9月2日DOI：https：//doi.org/10.1016/j.cgh.2020.09.004

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抽象
背景和目标
慢性乙型肝炎（CHB）病毒感染的干扰素-α（IFN-α）治疗是有限的，与核苷酸类似物（NA）治疗相比，可导致相对较高的功能治愈率（HBsAg损失）。在CHB患者的超长期随访中评估了聚乙二醇化（PEG）/常规IFN-α治疗对临床结局的影响。
方法
纳入1977-2014年间在三级转诊中心接受（PEG）IFN-α治疗的HBeAg阳性患者。我们检查了病历，并咨询了市政府有关患者的信息。如果缺少随访数据，则邀请患者在门诊就诊。终点包括血清HBeAg / HBsAg丢失和临床事件发生率，使用生命表方法和人年分析事件发生率。复诊后对患者进行检查。
结果
该研究队列包括267名患者，其中67％为男性，58％为白种人，中位年龄为32岁。中位随访时间为11。5年。 HBsAg丢失的5年和10年累积发生率分别为14％和32％。与HBsAg丢失率较高相关的基线因素是男性，白种人，基因型A，年龄≥40岁和肝硬化。接受短期（≤24周）治疗与长期（> 24周）治疗者之间的HBsAg丢失率无显着差异。 HBeAg和HBsAg的丢失均与改善临床结局密切相关。早期反应（HBeAg丢失）与更多的HBsAg丢失和更好的患者预后相关。
结论
在长期随访期间，从单次（PEG）IFN-α疗程中观察到HBsAg丢失率很高。它的持续作用表明，IFN-α的作用仍然存在，可能在寻求功能治愈的新型联合疗法中。
关键词

    病毒性肝炎
    免疫调节剂
    长期结果
    预后

StephenW

https://www.cghjournal.org/article/S1542-3565(20)31232-5/pdf

齐欢畅

HBsAg丢失的5年和10年累积发生率分别为14％和32％。

newchinabok

目前只有干挠素强一丢丢，有条件，能试就试一下，赌博一下，一生一试

乙肝人1949

嗯，目前，白莱，胡萝卜，只有胡萝卜营业价值高一点，那就多吃点胡萝卜