聚乙二醇干扰素-核苷类似物序贯优化治疗对HBeAg阳性CHB患者

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Efficacy of peg-interferon–nucleoside analog sequential optimization therapy in HBeAg-positive patients with CHB

    Wei Xu, Qiang Li, Chenlu Huang, Qiankun Hu, Xun Qi, Yuxian Huang, Jiming Zhang & Liang Chen

Hepatology International (2020)Cite this article

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Abstract
Objective

This study aimed to evaluate the efficacy of Peg-interferon (Peg-IFN)–nucleoside analog (NA) sequential optimization therapy (SOT) in HBeAg-positive patients with chronic hepatitis B (CHB).
Methods

In this prospective two-center study, 132 CHB patients were assigned to receive Peg-IFN standard therapy for 48 weeks (65 patients) or Peg-IFN monotherapy for 12–24 weeks and NA add-on for those without early virological response (EVR) (67 patients). Both patient groups were monitored and followed for 24 weeks after treatments stop.
Results

At week 24 after treatments stop, the Peg-IFN–NA SOT group achieved more HBsAg levels drop (− 1.35 vs − 0.67 log10 IU/mL, p = 0.016), higher HBsAg ≤ 100 IU/mL (32.8% vs 9.2%, p = 0.001), HBV DNA undetectable (79.1% vs 49.2%, p < 0.001), and ALT normalization (80.6% vs 38.5%, p < 0.001) rates compared with Peg-IFN monotherapy. At week 24 after treatments stop, no significant difference was found in HBeAg seroconversion (35.8% vs 27.7%, p = 0.316), HBsAg loss (8.9% vs 4.6%, p = 0.323) and HBsAg seroconversion rates (4.5% vs 1.5%, p = 0.325) between Peg-IFN monotherapy group and Peg-IFN–NA SOT group.
Conclusion

Starting with Peg-IFN followed by addition of NA achieved more HBsAg levels drop, and higher HBsAg ≤ 100 IU/mL, HBV DNA undetectable, and ALT normalization rates compared with Peg-IFN monotherapy.

StephenW

聚乙二醇干扰素-核苷类似物序贯优化治疗对HBeAg阳性CHB患者的疗效

    徐伟，李强，黄晨璐，胡倩k，X逊，黄玉贤，张继明，陈良

国际肝病学（2020）

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抽象
目的

本研究旨在评估聚乙二醇干扰素（Peg-IFN）-核苷类似物（NA）顺序优化疗法（SOT）在HBeAg阳性慢性乙型肝炎（CHB）患者中的疗效。
方法

在这项前瞻性的两中心研究中，将132名CHB患者分配为接受Peg-IFN标准治疗48周（65位患者）或接受Peg-IFN单药治疗12-24周，并且对无早期病毒学应答的患者进行NA附加治疗（EVR） ）（67位患者）。监测两个患者组，并在治疗停止后随访24周。
结果

在停止治疗后的第24周，Peg-IFN-NA SOT组的HBsAg水平下降更多（-1.35 vs-0.67 log10 IU / mL，p = 0.016），更高的HBsAg≤100 IU / mL（32.8％vs 9.2％，与Peg-IFN单药治疗相比，p <= 0.001），HBV DNA检出率（79.1％vs 49.2％，p << 0.001）和ALT正常化率（80.6％vs 38.5％，p << 0.001）。在停止治疗后的第24周，HBeAg血清转化率（35.8％vs 27.7％，p = 0.316），HBsAg损失（8.9％vs 4.6％，p = 0.323）和HBsAg血清转化率（4.5％vs 1.5％）无显着差异。 ，Peg-IFN单药治疗组和Peg-IFN-NA SOT组之间的比较，p = 0.325）。
结论

与Peg-IFN单药治疗相比，从Peg-IFN开始，随后添加NA可获得更多的HBsAg水平下降，更高的HBsAg≤≤100IU / mL，无法检测到HBV DNA和ALT正常化率。