HBeAg 阳性慢性乙型肝炎患者干扰素-α 诱导的持续 HBsAg 阴性

StephenW

HBeAg 阳性慢性乙型肝炎患者干扰素-α 诱导的持续 HBsAg 阴性反应需要巩固治疗
李明辉 1 , 孙芳芳 2 , 毕晓月 2 , 林彦杰 3 , 刘洋 2 , 姚璐 2 , 卢章 2 , 港湾 4 , 卫毅 5 , 临清赵 6 , 姚燮 7
隶属关系
隶属关系

    1
    首都医科大学北京地坛医院肝病二科，北京，100015；北京大学地坛教学医院肝病二科,北京 100015
    2
    首都医科大学北京地坛医院肝病二科,北京 100015
    3
    北京大学地坛教学医院肝病二科,北京 100015
    4
    首都医科大学北京地坛医院生物统计学科，北京，100015
    5
    首都医科大学北京地坛医院妇产科，北京，100015电子地址：[email protected]。
    6
    首都儿科研究所, 北京市儿童病毒病病原学重点实验室, 北京, 100020电子地址：[email protected]。
    7
    首都医科大学北京地坛医院肝病二科，北京，100015；北京大学地坛教学医院肝病二科,北京 100015电子地址：[email protected]。

    PMID：35257963 DOI：10.1016/j.virs.2022.03.001

抽象的

乙型肝炎表面抗原 (HBsAg) 清除被认为是慢性乙型肝炎 (CHB) 患者的功能性治愈。本研究旨在评估以干扰素为基础的治疗对乙型肝炎包膜抗原 (HBeAg) 呈阳性的慢性乙型肝炎患者的 HBsAg 清除持久性。在这项前瞻性研究中，HBeAg 阳性 CHB 患者在基于干扰素的治疗下确认 HBsAg 消失，在治疗结束后 12 周内入组，并随访 48 周。每3-6个月观察一次病毒学标志物、生化指标和肝脏影像学检查。持续功能治愈被分析为主要结果。还研究了与持续 HBsAg 消失或逆转相关的因素。 HBsAg 持续消失率为 91.8% (212/231)。接受巩固治疗 12-24 周或≥24 周的患者持续 HBsAg 阴性率高于接受巩固治疗 <12 周的患者（98.3% 和 91.2% 对 86.7%，P = 0.068），前组有抗 HBs 水平显着高于后者（P < 0.05）。 HBsAg 逆转和 HBV DNA 逆转的累积发生率分别为 8.2% 和 3.9%。 ≥ 12 周的巩固治疗 [比值比 (OR) 3.318, 95% 置信区间 (CI) 1.077-10.224, P = 0.037) 是持续功能性治愈和停止治疗时 HBeAg 阳性的预测因子 (OR 12.271, 95 % CI 1.076-139.919，P = 0.043）是 HBsAg 逆转的预测因子。干扰素-α 诱导的功能性治愈是持久的，HBeAg 阳性 CHB 患者 HBsAg 消失后需要 ≥ 12-24 周的巩固治疗。

关键词：慢性乙型肝炎（CHB）；功能性治愈； HBeAg 阳性； HBsAg 丢失；干扰素 (IFN)。

版权所有 © 2022 作者。 Elsevier B.V. 的出版服务保留所有权利。

StephenW

Consolidation treatment needed for sustained HBsAg-negative response induced by interferon-alpha in HBeAg positive chronic hepatitis B patients
Minghui Li  1 , Fangfang Sun  2 , Xiaoyue Bi  2 , Yanjie Lin  3 , Liu Yang  2 , Yao Lu  2 , Lu Zhang  2 , Gang Wan  4 , Wei Yi  5 , Linqing Zhao  6 , Yao Xie  7
Affiliations
Affiliations

    1
    Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China; Department of Hepatology Division 2, Peking University Ditan Teaching Hospital, Beijing, 100015, China.
    2
    Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China.
    3
    Department of Hepatology Division 2, Peking University Ditan Teaching Hospital, Beijing, 100015, China.
    4
    Department of Biostatistics, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China.
    5
    Department of Gynecology and Obstetrics, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China. Electronic address: [email protected].
    6
    Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics, Beijing, 100020, China. Electronic address: [email protected].
    7
    Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China; Department of Hepatology Division 2, Peking University Ditan Teaching Hospital, Beijing, 100015, China. Electronic address: [email protected].

    PMID: 35257963 DOI: 10.1016/j.virs.2022.03.001

Abstract

Hepatitis B surface antigen (HBsAg) clearance is considered as functional cure in patients with chronic hepatitis B (CHB). This study aimed to assess the durability of HBsAg clearance achieved by interferon-based therapies in patients with CHB who were originally positive for hepatitis B envelope antigen (HBeAg). In this prospective study, HBeAg-positive CHB patients with confirmed HBsAg loss under interferon-based therapies were enrolled within 12 weeks from end of treatment and followed up for 48 weeks. Virological markers, biochemical indicators, and liver imaging examinations were observed every 3-6 months. Sustained functional cure was analyzed as primary outcome. Factor associated with sustained HBsAg loss or reversion was also investigated. The rate of HBsAg loss sustainability was 91.8% (212/231). Patients receiving consolidation treatment for 12-24 weeks or ≥ 24 weeks had higher rates of sustained HBsAg negativity than those receiving consolidation treatment for < 12 weeks (98.3% and 91.2% vs. 86.7%, P = 0.068), and the former groups had significantly higher anti-HBs levels than the later (P < 0.05). The cumulative incidence of HBsAg reversion and HBV DNA reversion was 8.2% and 3.9%, respectively. Consolidation treatment of ≥ 12 weeks [odd ratio (OR) 3.318, 95% confidence interval (CI) 1.077-10.224, P = 0.037) was a predictor of sustained functional cure, and HBeAg-positivity at cessation of treatment (OR 12.271, 95% CI 1.076-139.919, P = 0.043) was a predictor of HBsAg reversion. Interferon-alpha induced functional cure was durable and a consolidation treatment of ≥ 12-24 weeks was needed after HBsAg loss in HBeAg-positive CHB patients.

Keywords: Chronic hepatitis B (CHB); Functional cure; HBeAg positive; HBsAg loss; Interferon (IFN).

Copyright © 2022 The Authors. Publishing services by Elsevier B.V. All rights reserved.

StephenW

https://www.sciencedirect.com/sc ... 22000554?via%3Dihub

newchinabok

StephenW 发表于 2022-3-9 20:39
https://www.sciencedirect.com/science/article/pii/S1995820X22000554?via%3Dihub

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