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肝胆相照论坛 论坛 学术讨论& HBV English 聚乙二醇干扰素α-2a治疗后HBeAg阴性慢性乙型肝炎患者早 ...
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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 [复制链接]

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发表于 2020-10-15 08:18 |只看该作者 |倒序浏览 |打印
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, Lu Zhang, Yao Lu, Qiqi Chen, Huihui Lu, Fangfang Sun, Zhan Zeng, Gang Wan, Linqing Zhao & Yao Xie

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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.

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发表于 2020-10-15 08:18 |只看该作者
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,张璐,陆瑶,陈启琦,陆慧慧,孙芳芳,曾增,万刚,赵林青&谢瑶

Virologica Sinica(2020)援引本文

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乙型肝炎表面抗原(HBsAg)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。在治疗初期和治疗后每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%。在第96周或第120周时,HBsAg丧失的临界值在24周时的预测能力要好于在第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丢失至关重要,并且在调整PEG-IFN治疗期间24周的HBsAg水平可用于预测HBsAg丢失。

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发表于 2020-10-15 12:53 |只看该作者
本帖最后由 newchinabok 于 2020-10-15 12:54 编辑

目前屈指可数的免疫药试验效果不好怎么办,你们觉得能绕过干挠素吗?你们觉得磕核苷药能长治久安吗?如果能够长治久安,还需研究新药干嘛?
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