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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 [复制链接]

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发表于 2020-9-16 22:18 |只看该作者 |倒序浏览 |打印
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

This paper is only available as a PDF. To read, Please Download here.
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

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发表于 2020-9-16 22:18 |只看该作者
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
    显示所有作者

发布时间:2020年9月2日DOI:https://doi.org/10.1016/j.cgh.2020.09.004

本文仅以PDF格式提供。要阅读,请在此处下载。
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

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发表于 2020-9-16 22:19 |只看该作者

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发表于 2020-9-16 23:08 |只看该作者
HBsAg丢失的5年和10年累积发生率分别为14%和32%。

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发表于 2020-9-17 00:02 |只看该作者
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

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发表于 2020-9-17 12:51 |只看该作者
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
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