慢性乙型肝炎患者聚乙二醇干扰素α-2a单一疗法中与乙型肝

StephenW

Factors Associated with Hepatitis B Surface Antigen Kinetics and Responses in Pegylated Interferon Alpha-2a Monotherapy for Patients with Chronic Hepatitis B
Norio Itokawa  1 , Masanori Atsukawa  1   2 , Akihito Tsubota  3 , Noritomo Shimada  4 , Hidenori Toyoda  5 , Koichi Takaguchi  6 , Atsushi Hiraoka  7 , Tomonori Senoh  6 , Mai Koeda  1 , Yuji Yoshida  1 , Tomomi Okubo  1 , Taeang Arai  1 , Korenobu Hayama  1 , Ai Nakagawa-Iwashita  1 , Chisa Kondo  2 , Katsuhiko Iwakiri  2
Affiliations
Affiliations

    1
    Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School Chiba Hokusoh Hospital, Japan.
    2
    Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Japan.
    3
    Core Research Facilities, The Jikei University School of Medicine, Japan.
    4
    Department of Internal Medicine, Division of Gastroenterology and Hepatology, Otakanomori Hospital, Japan.
    5
    Department of Gastroenterology, Ogaki Municipal Hospital, Japan.
    6
    Department of Hepatology, Kagawa Prefectural Central Hospital, Japan.
    7
    Gastroenterology Center, Ehime Prefectural Central Hospital, Japan.

    PMID: 33583931 DOI: 10.2169/internalmedicine.5432-20

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Abstract

Objective Pegylated-interferon monotherapy is the standard treatment for patients with chronic hepatitis B; however, the factors associated with its therapeutic effects remain unclear. Methods Patients with chronic hepatitis B were treated with pegylated interferon α-2a for 48 weeks. We evaluated the kinetics of hepatitis B surface antigen (HBsAg) during treatment and follow-up periods and the factors associated with an HBsAg response (defined as a change in HBsAg of ≥-1 log IU/mL from baseline). Results The study population comprised 50 patients. The median baseline levels of hepatitis B virus DNA and HBsAg were 5.00 and 3.40 log IU/mL. The median values of HBsAg reduction from baseline were -0.44 (n=48), -0.41 (n=40), and -0.68 (n=11) log IU/mL at the end of treatment and at 48 and 144 weeks post-treatment, respectively. The rates of HBsAg response were 24.0% and 22.5% at the end of treatment and at 48 weeks post-treatment, respectively. A multivariate analysis identified HBsAg <3.00 log IU/mL as an independent baseline factor contributing to the HBsAg response at the end of treatment and 48 weeks post-treatment (p=1.07×10-2 and 4.42×10-2, respectively). There were significant differences in the reduction of the HBsAg levels at 12 weeks of treatment and in the incidence of serum ALT increase during treatment between patients with and without an HBsAg response. Conclusion These findings suggest that the baseline HBsAg level, HBsAg kinetics at 12 weeks of treatment, and ALT increase during treatment are important factors contributing to the HBsAg response in pegylated interferon α-2a monotherapy for patients with chronic hepatitis B.

Keywords: HBsAg response; hepatitis B surface antigen (HBsAg) kinetics; pegylated interferon alpha-2a monotherapy.

StephenW

慢性乙型肝炎患者聚乙二醇干扰素α-2a单一疗法中与乙型肝炎表面抗原动力学相关的因素
to川纪夫1，an川正德1，博仁明仁3 2，岛田纪仁4，丰田秀典5，高口孝一6，平田淳7，户田守千野6，舞田枝希1，吉田裕司1，大久保友美1，大井新井1，K野部羽山1，中川爱蓝1，近藤千纱2，岩aki胜彦2
隶属关系
隶属关系

    1个
    日本日本医学院千叶北s医院内科消化内科。
    2
    日本日本医学院内科消化内科和肝病科。
    3
    日本计财大学医学院核心研究设施。
    4
    日本大高森医院消化内科，消化内科。
    5
    日本大垣市立医院消化内科。
    6
    日本香川县立中央医院肝病科。
    7
    日本爱媛县中央医院消化内科中心。

    PMID：33583931 DOI：10.2169 / internalmedicine.5432-20

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抽象的

目的聚乙二醇干扰素单药治疗是慢性乙型肝炎的标准治疗方法。然而，与其治疗效果相关的因素仍不清楚。方法对慢性乙型肝炎患者进行聚乙二醇干扰素α-2a治疗48周。我们评估了治疗和随访期间乙型肝炎表面抗原（HBsAg）的动力学以及与HBsAg反应相关的因素（定义为HBsAg与基线相比≥-1 log IU / mL的变化）。结果研究人群包括50名患者。乙型肝炎病毒DNA和HBsAg的中位基线水平为5.00和3.40 log IU / mL。在治疗结束时以及治疗后48周和144周，相对于基线水平，HBsAg降低的中位数分别为-0.44（n = 48），-0.41（n = 40）和-0.68（n = 11）log IU / mL。治疗分别。治疗结束时和治疗后48周时HBsAg反应率分别为24.0％和22.5％。多元分析确定HBsAg <3.00 log IU / mL是导致治疗结束和治疗后48周HBsAg反应的独立基线因素（分别为p = 1.07×10-2和4.42×10-2）。在有和没有HBsAg反应的患者之间，治疗12周时HBsAg水平的降低和治疗期间血清ALT升高的发生率存在显着差异。结论这些发现表明，在慢性乙型肝炎患者中，聚乙二醇化干扰素α-2a单一疗法的基线HBsAg水平，治疗12周时HBsAg动力学以及治疗期间ALT升高是有助于HBsAg反应的重要因素。

关键字：HBsAg反应；乙型肝炎表面抗原（HBsAg）动力学；聚乙二醇干扰素α-2a单药治疗。

StephenW

https://www.jstage.jst.go.jp/art ... 0/4/60_5432-20/_pdf