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肝胆相照论坛 论坛 学术讨论& HBV English 乙型肝炎抗原阳性的慢性乙型肝炎患者的粪便菌群移植:一 ...
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乙型肝炎抗原阳性的慢性乙型肝炎患者的粪便菌群移植:一 [复制链接]

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发表于 2021-3-6 20:20 |只看该作者 |倒序浏览 |打印
Fecal Microbiota Transplantation in Hepatitis B e Antigen-Positive Chronic Hepatitis B Patients: A Pilot Study

    Ashish Chauhan, Ramesh Kumar, Sanchit Sharma, Mousumi Mahanta, Sudheer K. Vayuuru, Baibaswata Nayak, Sonu Kumar & Shalimar

Digestive Diseases and Sciences volume 66, pages873–880(2021)Cite this article

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Abstract
Background

Intestinal flora plays a critical role in immunity against hepatitis B virus (HBV). Fecal Microbiota Transplantation (FMT) may be a potential immunomodulatory therapy in patients with chronic hepatitis B (CHB).
Aim

We aimed to study role of FMT in hepatitis B e antigen (HBeAg)-positive CHB patients in terms of its effect on HBeAg, HBsAg, and HBV DNA.
Methods

HBeAg-positive patients despite being on antiviral treatment for > 1 year were given six cycles of FMT via gastroscope (nasoduodenal route) at 4 weekly intervals along with antiviral therapy. Twelve out of 14 included patients in FMT arm completed six cycles. Another 15 HBeAg-positive patients who were on oral antivirals for > 1 year were taken as control—antiviral therapy (AVT) arm. Per-protocol analysis was done.
Results

The median (interquartile range) age in the FMT and AVT arm were 29 (25–35) and 29(24–38), respectively (P = 0.794). The median (interquartile range) duration of AVT prior to inclusion in the study was 80 (52–104) and 76 (52–114) months in FMT and AVT arm, respectively (P = 0.884). In the FMT arm, 16.7% (2/12) patients had HBeAg clearance in comparison to none in the AVT arm (P = 0.188). None of the patients in either arm had HBsAg loss. The FMT was tolerated well, 42.8% (6/14) patients reported one or more minor adverse events.
Conclusions

In this non-randomized pilot study, FMT appears to be safe and potentially effective in terms of viral suppression and HBeAg clearance in patients with HBeAg-positive CHB. Further randomized controlled trials are needed in order to obtain robust conclusions.

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发表于 2021-3-6 20:20 |只看该作者
乙型肝炎抗原阳性的慢性乙型肝炎患者的粪便菌群移植:一项初步研究

    Ashish Chauhan,Ramesh Kumar,Sanchit Sharma,Mousu​​mi Mahanta,Sudheer K.Vayuuru,Baibaswata Nayak,Sonu Kumar和Shalimar

消化系统疾病,第66卷,第873–880页(2021),引用本文

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抽象的
背景

肠道菌群在抵抗乙型肝炎病毒(HBV)的免疫中起着至关重要的作用。粪便微生物菌群移植(FMT)可能是慢性乙型肝炎(CHB)患者的一种潜在的免疫调节疗法。
目的

我们旨在研究FMT在乙型肝炎e抗原(HBeAg)阳性CHB患者中的作用,根据其对HBeAg,HBsAg和HBV DNA的影响。
方法

尽管接受抗病毒治疗超过1年的HBeAg阳性患者通过胃镜(鼻十二指肠途径)每隔4周一次进行了六个周期的FMT联合抗病毒治疗。 FMT组的14名患者中有12名完成了6个周期。接受口服抗病毒药物治疗≥1年的15例HBeAg阳性患者被作为对照组-抗病毒治疗(AVT)组。按协议进行分析。
结果

FMT和AVT组的中位年龄(四分位间距)分别为29岁(25-35岁)和29岁(24-38岁)(P = 0.794)。在纳入研究之前,FMT和AVT组中AVT的中位(四分位间距)持续时间分别为80(52–104)和76(52–114)月(P = 0.884)。在FMT组中,有16.7%(2/12)的患者具有HBeAg清除率,而在AVT组中则没有(P = 0.188)。两组的患者均无HBsAg丢失。 FMT的耐受性良好,有42.8%(6/14)的患者报告了一种或多种轻微不良事件。
结论

在这项非随机的先导研究中,就HBeAg阳性CHB患者的病毒抑制和HBeAg清除而言,FMT似乎是安全且潜在有效的。为了获得可靠的结论,还需要进一步的随机对照试验。
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