基于聚乙二醇化干扰素 Alfa-2a 的联合和间歇疗法治疗慢性乙

StephenW

基于聚乙二醇化干扰素 Alfa-2a 的联合和间歇疗法治疗慢性乙型肝炎与核苷（核苷酸）类似物的经验导致乙型肝炎表面抗原清除：病例报告

林彦杰
, 孙芳芳
, 展增
,毕晓月
, 刘洋
, 李明辉
, 和姚谢
在线发布：2021年10月28日https://doi.org/10.1089/vim.2021.0112

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抽象的

干扰素（IFN）和核苷（核苷酸）类似物（NAs）是两种有效的慢性乙型肝炎（CHB）抗病毒药物。越来越多的证据表明，两种药物联合应用可以更好地抑制病毒复制，甚至达到临床治愈。干扰素间歇治疗也被认为是在基于干扰素的抗病毒治疗期间乙肝表面抗原（HBsAg）下降出现停滞时解决干扰素疲劳的重要措施。一名 36 岁男性乙型肝炎 e 抗原 (HBeAg) 阳性 CHB 接受过 NA 病史患者入院。在对富马酸替诺福韦二吡呋酯（TDF）单药治疗 1 年反应不佳后，患者接受聚乙二醇化干扰素 alfa-2a 联合治疗，最终达到 HBsAg 清除。在治疗和随访期间，每3个月监测一次HBsAg、HBeAg、乙型肝炎病毒（HBV）DNA、血清丙氨酸转氨酶等。在联合治疗的第 58 周和第 71 周之间，由于 HBsAg 下降缓慢而停用 IFN，而单独使用 TDF 进行维持治疗。分别在第 44、96 和 122 周观察到完全病毒学应答、HBeAg 和 HBsAg 血清学转换。巩固治疗24周后，HBsAg、HBeAg、HBV DNA均呈阴性，联合治疗第146周乙肝表面抗体为729.30 mIU/mL，停药。在停止治疗 28 周后随访，患者仍保持临床治愈。

StephenW

Combination and Intermittent Therapy Based on Pegylated Interferon Alfa-2a for Chronic Hepatitis B with Nucleoside (Nucleotide) Analog-Experienced Resulting in Hepatitis B Surface Antigen Clearance: A Case Report

Yan-jie Lin
, Fang-fang Sun
, Zhan Zeng
, Xiao-yue Bi
, Liu Yang
, Ming-hui Li
, and Yao Xie
Published Online:28 Oct 2021https://doi.org/10.1089/vim.2021.0112

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Abstract

Interferon (IFN) and nucleoside (nucleotide) analogs (NAs) are two effective antiviral drugs for chronic hepatitis B (CHB). More and more evidence shows that the combination of the two drugs can better inhibit viral replication and even achieve clinical cure. IFN intermittent therapy is also considered to be an important measure to resolve IFN fatigue when hepatitis B surface antigen (HBsAg) decline appears stagnated during IFN-based antiviral therapy. A 36-year-old male NA-experienced patient with hepatitis B e antigen (HBeAg)-positive CHB was admitted to our hospital. After a poor response to tenofovir disoproxil fumarate (TDF) monotherapy for 1 year, the patient was treated with pegylated interferon alfa-2a combination therapy and finally achieved HBsAg clearance. During the treatment and follow-up, HBsAg, HBeAg, hepatitis B virus (HBV) DNA, and serum alanine aminotransferase, etc. were monitored every 3 months. Between weeks 58 and 71 of combination therapy, IFN was discontinued because of a slow decline in HBsAg, and TDF alone was used for maintenance therapy. Complete virological response, HBeAg and HBsAg seroconversion were observed at weeks 44, 96, and 122, respectively. After 24 weeks of consolidation therapy, HBsAg, HBeAg, and HBV DNA were consistently negative, and hepatitis B surface antibody was 729.30 mIU/mL at week 146 of the combination therapy, then we stopped drugs. Following up after 28 weeks of cessation therapy, the patient still remained clinically cured.

StephenW

https://www.liebertpub.com/doi/1 ... November+11%2C+2021