舒丹,许诚,王松,纪燕华,蒋育进,王彦丰,才袁,汪莹,曾丽红
SHU Dan,XU Cheng,WANG Song,JI Yanghua,JIANG Yujin,WANG Yanfeng,CAI Yuan,WANG Ying,ZENG Lihong

• 1:深圳市第三人民医院肝病三科

摘要(Abstract)：

目的评价根据聚乙二醇干扰素-α(Peg-IFN-α)治疗24周应答情况进行优化治疗的疗效。方法选取HBe Ag阳性慢性乙型肝炎(CHB)初治患者,观察组采用Peg-IFN-α,疗程24周HBV DNA下降≤2 log10 IU/m L定义为早期应答不佳,采取继续原方案(IFN亚组)或转用恩替卡韦(ETV)的不同策略;对照组使用ETV。每12周检测HBV DNA及乙肝病毒学标志物(HBV m)。结果观察组62例,有44例纳入早期应答不佳,其中29例纳入ETV亚组,15例纳入IFN亚组;对照组32例。疗程96周时,ETV亚组的HBe Ag血清学转换率达59%,高于对照组(25%)与IFN亚组(27%)(χ2=0.27、7.11,P=0.04、<0.01)。ETV亚组的HBs Ag下降幅度大于IFN亚组。结论根据Peg-IFN-α早期应答情况进行优化治疗可能提高HBe Ag血清学转换率。
OBJECTIVE To investigate the efficacy of optimal therapy strategies for hepatitis B e antigen( HBe Ag) positive chronic hepatitis B( CHB) patients with suboptimal response to Peg-interferon-α( Peg-IFN-α) at 24-week. METHODS The cases of HBe Ag-positive CHB were enrolled into IFN group or entecavir( ETV) group. Suboptimal response was defined as a decrease in HBV DNA of ≤2 log10 IU / m L after 24 weeks of IFN therapy. Based on patient preference,part of the patients with suboptimal response switched to ETV. Hepatitis B virus( HBV) viralogical and serological data were collected every 12 weeks. RESULTS Among 62 patients in IFN group,44 hade suboptimal response. 29 cases switched to ETV and 15 cases went on Peg-IFN-α therapy. After 96 weeks of treatment,The patients switch-to ETV strategy had better HBe Ag seroconversion efficiency compared with go-on IFN strategy( 59% vs27%,χ2= 7.11,P<0.01) or ETV group( 59% vs 25%,χ2= 0.27,P = 0.04). The magnitude of HBs Ag decline was larger in switch-to ETV patients than that of go-on IFN patients. CONCLUSION The optimized treatment for CHB with suboptimal response to Peg-IFN-α could achieve a higher HBe Ag seroconversion rate.

关键词(KeyWords)： 肝炎,乙型,慢性;肝炎e抗原,乙型;聚乙烯二醇类;干扰素一α;恩替卡韦
hepatitis B;chronic;hepatitis B e antigens;Polyethylene glycols;interferon alfa;entecavir

Abstract:

Keywords:

基金项目(Foundation): 广东省药学会肝炎用药研究基金(2012G25)

作者(Author): 舒丹,许诚,王松,纪燕华,蒋育进,王彦丰,才袁,汪莹,曾丽红
SHU Dan,XU Cheng,WANG Song,JI Yanghua,JIANG Yujin,WANG Yanfeng,CAI Yuan,WANG Ying,ZENG Lihong

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