干擾素附加治療顯著提高了接受干擾素治療的低 HBsAg 慢性乙

StephenW

干擾素附加治療顯著提高了接受干擾素治療的低 HBsAg 慢性乙型肝炎患者的臨床治愈率
楊小安 1 2 , 張卡 1 2 , 許啟煥 1 2 , 新舒 1 2 , 莫志碩 1 2 , 謝東營 1 2 , 高志良 1 2 , 鄧宏 1 2
隸屬關係
隸屬關係

    1
    【作者單位】： 中山大學第三附屬醫院感染科;
    2
    廣東省肝病研究重點實驗室，中山大學第三附屬醫院，廣州，中國。

    PMID：36148219 PMCID：PMC9485616 DOI：10.3389/fimmu.2022.997608

抽象的

目前，干擾素附加治療為低HBsAg的慢性乙型肝炎患者的臨床治愈帶來了希望。然而，在臨床實踐中，對第一次干擾素治療反應不佳的患者經常被轉換為核苷（酸）類似物治療，然後被標記為不適合干擾素治療的患者。即使他們的 HBsAg 水平下降到較低水平，他們也不願意或不建議再次服用乾擾素，這導致他們錯過了乾擾素附加治療和臨床治愈。因此，迫切需要闡明干擾素附加療法的有效性，以使這些接受過乾擾素的低HBsAg患者獲得臨床治愈。本研究的目的是調查接受過乾擾素治療的患者是否可以達到與未接受過乾擾素治療的患者相同的 HBsAg 清除率和 HBsAg 血清學轉換率。此外，旨在闡明 HBsAg 清除和血清轉換的相關因素。 HBsAg<1500 IU/ml、HBeAg 陰性和 HBV-DNA 陰性的 292 名患者，包括 85 名接受過乾擾素治療的患者入組。然後，進行peg-干擾素α-2b附加治療。結果顯示，48週所有患者HBsAg清除率和血清轉換率分別為29.8%和22.0%。在第 48 週 HBsAg 清除率和血清轉換率方面，接受過乾擾素的患者和未接受過乾擾素的患者之間沒有統計學上的顯著差異，表明干擾素附加治療對接受過乾擾素的患者的臨床治愈令人滿意。年齡、基線 HBsAg 和第 12 週 HBsAg 是第 48 週 HBsAg 清除和血清轉換的負相關因素。此外，用於預測第 48 週 HBsAg 清除的年齡、基線 HBsAg 和第 12 週 HBsAg 在 40.5 歲、152.0 IU/ml 和 34.99 IU/ml 時被切斷，而用於預測血清轉化的預測在 40.5 歲時被切斷，為 181.9 IU/ml 和 34.99 IU/ml，相應地。值得一提的是，建議對HBsAg低的干擾素患者進行干擾素附加治療，以盡快達到臨床治愈。該研究為乾擾素附加治療慢性乙型肝炎提供了證據和臨界值。

關鍵詞：HBsAg；慢性乙型肝炎患者（CHB）；臨床治愈；干擾素附加療法；干擾素經驗豐富的患者。

版權所有 © 2022 楊、張、徐、舒、莫、謝、高、鄧。
利益衝突聲明

作者聲明，該研究是在沒有任何可能被解釋為潛在利益衝突的商業或財務關係的情況下進行的。

StephenW

Interferon add-on therapy increased clinical cure significantly for interferon-experienced chronic hepatitis B patients with low HBsAg
Xiaoan Yang  1   2 , Ka Zhang  1   2 , Qihuan Xu  1   2 , Xin Shu  1   2 , Zhishuo Mo  1   2 , Dongying Xie  1   2 , Zhiliang Gao  1   2 , Hong Deng  1   2
Affiliations
Affiliations

    1
    Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
    2
    Guangdong Provincial Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

    PMID: 36148219 PMCID: PMC9485616 DOI: 10.3389/fimmu.2022.997608

Abstract

Currently, interferon add-on therapy brings hope for clinical cure of chronic hepatitis B patients with low HBsAg. However, in clinical practice patients with poor responses to their first interferon therapy were often switched to nucleos(t)ide analog therapy and then labeled as unsuitable patients for interferon therapy. Even if their HBsAg levels dropped to a low level, they were reluctant or not recommended to take interferon again, which caused them to miss out on interferon add-on therapy and clinical cure. Therefore, it is urgent to elucidate the effectiveness of interferon add-on therapy to get clinical cure for these interferon-experienced patients with low HBsAg. The purpose of this study was to investigate whether interferon-experienced patients could achieve the same HBsAg clearance and HBsAg seroconversion rates as interferon-naive patients. Also, the associated factor of HBsAg clearance and seroconversion were aimed to be clarified. 292 patients, including 85 interferon-experienced patients, were enrolled with HBsAg< 1500 IU/ml, HBeAg negative and HBV-DNA negative. And then, peg-interferon α-2b add-on therapy was performed. The results showed that the week 48 HBsAg clearance and seroconversion rates of all patients were 29.8% and 22.0%. There was no statistically significant difference between interferon-experienced and interferon-naive patients in week 48 HBsAg clearance and seroconversion rates, suggesting satisfactory clinical cure of the interferon add-on therapy for interferon-experienced patients. The age, baseline HBsAg, and week 12 HBsAg were negative correlated factors for week 48 HBsAg clearance and seroconversion. Furthermore, the age, baseline HBsAg and week 12 HBsAg for predicting the week 48 HBsAg clearance were cut off at 40.5 years, at 152.0 IU/ml and at 34.99 IU/ml, and for predicting seroconversion were cut off at 40.5 years, at 181.9 IU/ml and at 34.99 IU/ml, correspondingly. Significantly, interferon-experienced patients with low HBsAg were suggested with interferon add-on therapy to achieve clinical cure as soon as possible. This research provided evidences and cut-offs for the interferon add-on therapy against chronic hepatitis B.

Keywords: HBsAg; chronic hepatitis B patients (CHB); clinical cure; interferon add-on therapy; interferon-experienced patients.

Copyright © 2022 Yang, Zhang, Xu, Shu, Mo, Xie, Gao and Deng.
Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.