恩替卡韦或替诺福韦与聚乙二醇化干扰素-α的组合可长期降

StephenW

Combination of Entecavir or Tenofovir with Pegylated Interferon-α for Long-Term Reduction in Hepatitis B Surface Antigen Levels: Simultaneous, Sequential, or Add-on Combination Therapy
Kanako Yoshida  1 , Masaru Enomoto  1 , Akihiro Tamori  1 , Shuhei Nishiguchi  2   3 , Norifumi Kawada  1
Affiliations
Affiliations

    1
    Department of Hepatology, Graduate School of Medicine, Osaka City University, Osaka 545-8585, Japan.
    2
    Division of Medical Science of Regional Cooperation for Liver Diseases, Graduate School of Medicine, Osaka City University, Osaka 545-8585, Japan.
    3
    Department of Internal Medicine, Kano General Hospital, Osaka 531-0041, Japan.

    PMID: 33535672 DOI: 10.3390/ijms22031456

Abstract

Seroclearance of hepatitis B surface antigen (HBsAg) ("functional cure") is the optimal endpoint of antiviral therapy for chronic hepatitis B virus (HBV) infection. Currently available anti-HBV therapy includes nucleoside/nucleotide analogs (NAs) and peginterferon-α (Peg-IFNα). Combination of NAs and Peg-IFNα, each with different mechanisms of action, is an attractive approach for treating chronic HBV infection. In earlier studies, compared with monotherapy using IFNα, combination therapy showed greater on-treatment HBV DNA suppression but no difference in the sustained response. However, responses to the combination of non-pegylated IFNα with lamivudine or adefovir were not assessed based on HBsAg quantification but were defined by normal alanine aminotransferase levels, testing negative for hepatitis B e-antigen, and low HBV DNA load over a short term. Here, we reviewed previous reports regarding the effects of combination therapy of entecavir or tenofovir with Peg-IFNα, focusing on long-term reduction in HBsAg levels. Regimens of combination therapy were classified into "simultaneous" combination ("de novo" strategy); "sequential" combination, which involved starting with one therapy followed by the other ("switch-to" strategy); "add-on" combination, which involved adding Peg-IFNα to an ongoing NAs. Some studies have shown promising results, but there is no robust evidence that combination therapy is superior to monotherapy. Large studies are needed to assess the safety and efficacy of combination therapies to increase the rates of HBsAg seroclearance over the long term.

Keywords: ETV; HBV; HBsAg; TDF; chronic hepatitis B; peginterferon-α.

StephenW

恩替卡韦或替诺福韦与聚乙二醇化干扰素-α的组合可长期降低乙型肝炎表面抗原水平：同时，序贯或附加联合治疗
吉田加奈子1，江本正1，秋田昭宏1，西口周平2 3，川田典史1
隶属关系
隶属关系

    1个
    大阪市立大学大学院医学系研究科，大阪545-8585。
    2
    大阪市立大学大学院医学研究科肝脏疾病区域合作医学科，日本大阪545-8585。
    3
    日本大阪市鹿野总医院内科，大阪531-0041

    PMID：33535672 DOI：10.3390 / ijms22031456

抽象

乙肝表面抗原（HBsAg）的血清清除（“功能性治愈”）是慢性乙肝病毒（HBV）感染的抗病毒治疗的最佳终点。当前可用的抗HBV疗法包括核苷/核苷酸类似物（NAs）和聚乙二醇干扰素-α（Peg-IFNα）。 NAs和Peg-IFNα的组合具有不同的作用机制，是治疗慢性HBV感染的一种有吸引力的方法。在较早的研究中，与使用IFNα的单一疗法相比，联合疗法显示治疗中HBV DNA抑制作用更大，但持续反应无差异。但是，未根据HBsAg定量评估未聚乙二醇化IFNα与拉米夫定或阿德福韦联合使用的反应，但定义为正常丙氨酸氨基转移酶水平，乙型肝炎e抗原测试阴性，短期内HBV DNA负荷低。在这里，我们回顾了有关恩替卡韦或替诺福韦与Peg-IFNα联合治疗的效果的先前报道，重点是HBsAg水平的长期降低。联合治疗的方案被分为“同时”联合治疗（“从头开始”策略）； “顺序”组合，涉及从一种疗法开始，然后是另一种疗法（“转向”策略）； “附加”组合，涉及将Peg-IFNα添加到进行中的NAs中。一些研究显示了令人鼓舞的结果，但是没有强有力的证据表明联合治疗优于单一治疗。需要进行大量研究来评估联合治疗的安全性和有效性，以长期提高HBsAg血清清除率。

关键字：ETV；乙肝病毒乙肝表面抗原TDF;慢性乙型肝炎聚乙二醇干扰素-α。

StephenW

https://www.mdpi.com/1422-0067/22/3/1456/pdf