聚乙二醇干扰素α-2a治疗后HBeAg阴性慢性乙型肝炎患者早期血

StephenW

Early Serum HBsAg Kinetics as Predictor of HBsAg Loss in Patients with HBeAg-Negative Chronic Hepatitis B after Treatment with Pegylated Interferonα-2a
Minghui Li  1   2 , Lu Zhang  1 , Yao Lu  1 , Qiqi Chen  2 , Huihui Lu  1 , Fangfang Sun  1 , Zhan Zeng  2 , Gang Wan  3 , Linqing Zhao  4 , Yao Xie  5   6
Affiliations
Affiliations

    1
    Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China.
    2
    Department of Hepatology Division 2, Peking University Ditan Teaching Hospital, Beijing, 100015, China.
    3
    Department of Biostatistics, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China.
    4
    Laboratory of Virology Capital Institute of Pediatrics, Beijing, 100020, China. [email protected].
    5
    Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China. [email protected].
    6
    Department of Hepatology Division 2, Peking University Ditan Teaching Hospital, Beijing, 100015, China. [email protected].

    PMID: 32975731 DOI: 10.1007/s12250-020-00290-7

Abstract

Hepatitis B surface antigen (HBsAg) loss is an ideal treatment endpoint for patients with chronic hepatitis B (CHB). We investigated the predictive value of on-treatment HBsAg levels for HBsAg loss in hepatitis B e antigen (HBeAg)-negative CHB patients who received 120-week PEG-IFNα-2a treatment. Serum HBV DNA, HBsAg, and anti-HBs levels were assayed at baseline and every 3 months during the treatment. Of 81 patients, 12 achieved HBsAg loss, 20 achieved HBsAg < 100 IU/mL, and 49 maintained HBsAg ≥ 100 IU/mL. HBsAg loss rate was only 3.7% at 48 weeks, while it reached to 11.1% and 14.8% after treatment of 96 weeks and 120 weeks. The cutoff HBsAg levels at 12 weeks predicting HBsAg loss at 96 weeks and 120 weeks of treatment were 400 IU/mL and 750 IU/mL, with AUC 0.725 and 0.722, positive predictive value (PPV) 29.41% and 30.56%, and negative predictive value (NPV) 93.75% and 97.78%, respectively. The cutoff HBsAg levels at 24 weeks predicting HBsAg loss at 96 weeks and 120 weeks of treatment were 174 IU/mL and 236 IU/mL respectively, with AUC 0.925 and 0.922, PPV 40.0% and 46.15%, and both NPV 100%. The predictive ability of the cutoff HBsAg levels at 24 weeks was better than that at 12 weeks for HBsAg loss at either 96 or 120 weeks (χ2 = 3.880, P = 0.049 and χ2 = 4.412, P = 0.036). These results indicate that extended therapy is critical to HBsAg loss in HBeAg-negative CHB patients during PEG-IFN treatment, and the HBsAg level at 24 weeks can be used to predict HBsAg loss during tailoring PEG-IFN therapy.

Keywords: Chronic hepatitis B (CHB); HBeAg negative; HBsAg loss; Hepatitis B surface antigen (HBsAg); Pegylated interferon.

StephenW

聚乙二醇干扰素α-2a治疗后HBeAg阴性慢性乙型肝炎患者早期血清HBsAg动力学可预测HBsAg丢失
李明慧1 2，陆章1，姚路1，陈其琦2，回辉路1，孙芳芳1，詹增2，港湾3，赵临清4，姚谢5 6
隶属关系
隶属关系

    1个
    首都医科大学附属北京地坛医院肝病科2，北京100015
    2
    北京大学地坛教学医院第二医院肝科，北京100015
    3
    首都医科大学附属北京地坛医院生物统计学教研室，北京100015
    4
    首都儿科病毒研究所，北京100020 [email protected]。
    5
    首都医科大学附属北京地坛医院肝病科2，北京100015 [email protected]。
    6
    北京大学地坛教学医院第二医院肝科，北京100015 [email protected]。

    PMID：32975731 DOI：10.1007 / s12250-020-00290-7

抽象

乙型肝炎表面抗原（HBsAg）的丢失是慢性乙型肝炎（CHB）患者的理想治疗终点。我们调查了接受120周PEG-IFNα-2a治疗的乙型肝炎e抗原（HBeAg）阴性的CHB患者治疗中HBsAg水平对HBsAg丢失的预测价值。在治疗初期和治疗期间每3个月检测一次血清HBV DNA，HBsAg和抗HBs水平。在81例患者中，有12例达到HBsAg丢失，20例达到HBsAg <100 IU / mL，49例维持HBsAg≥100 IU / mL。 HBsAg丢失率在48周时仅为3.7％，而在治疗96周和120周后分别达到11.1％和14.8％。预测在治疗96周和120周时HBsAg丧失的12周时HBsAg截止水平为400 IU / mL和750 IU / mL，AUC为0.725和0.722，阳性预测值（PPV）为29.41％和30.56％，阴性预测为价值（NPV）分别为93.75％和97.78％。预测治疗96周和120周时HBsAg丧失的24周时HBsAg截止水平分别为174 IU / mL和236 IU / mL，AUC为0.925和0.922，PPV为40.0％和46.15％，两者均为NPV 100％。在96周或120周时，HBsAg丧失的24周时的预测能力要好于12周时的预测能力（χ2 = 3.880，P = 0.049，χ2 = 4.412，P = 0.036）。这些结果表明，延长治疗对于PEG-IFN治疗期间HBeAg阴性CHB患者的HBsAg丧失至关重要，并且在调整PEG-IFN治疗期间24周的HBsAg水平可用于预测HBsAg丧失。

关键字：慢性乙型肝炎（CHB）； HBeAg阴性； HBsAg丢失；乙型肝炎表面抗原（HBsAg）；聚乙二醇化干扰素。

newchinabok

干挠素转阴率低，而且和病人免疫应答有关，所以全是碰运气