Clinical study of IFNα-2b alone or in combination with lamivudine for HBeAg positive chronic hepatitis B
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摘要: 目的比较干扰素α-2b联合拉米夫定与单用干扰素α-2b及单用拉米夫定三种不同疗法,治疗HBeAg阳性慢性乙型肝炎(CHB)的疗效。方法三个治疗中心针对259名HBeAg阳性CHB进行抗病毒治疗的临床研究。其中单用干扰素α-2b(A)组82名患者;干扰素α-2b联合拉米夫定(B)组88名患者;单用拉米夫定(C)组89名患者。对照分析各组治疗12、24、36、48周时以及随访第72周时,血清ALT复常率、HBV DNA阴转率和血清HBV标志物的变化。观察不良反应以及乙型肝炎病毒耐药情况。结果 (1)三组患者治疗各时间点血清ALT复常率比较,差异无统计学意义(P>0.05)。(2)干扰素α-2b联合拉米夫定组抗病毒治疗48周时,HBeAg阴转率和血清学转换率分别为39.67%和31.59%,与A组和C组比较差异有统计学意义(P<0.05)。(3)单用干扰素α-2b组抗病毒治疗48周时,血清HBeAg阴转率和转换率分别为30.29%和29.27%,与单用拉米夫定组的6.74%和5.62%比较差异具有统计学意义(P<0.05);(4)干扰素α-2b联合拉米夫定组和单用拉米夫定组...Abstract: Objective To compare the efficacy of combination therapy of rh interferon α-2b (Kinferon) & lamivudine, mono-therapy of Kinferon and mono-therapy of lamivudine, in the treatment of patients with hepatitis B e antigen (HBeAg) positive chronic hepatitis B (CHB) .Methods Total 344 HBeAg positive CHB patients were enrolled and randomly divided into three groups: mono-therapy of Kinferon (Group A, n=116) ;combination therapy of Kinferon & lamivudine (Group B, n=103) ;mono-therapy of lamivudine (group C, n=125) .Changes of serum ALT normalization rate, no detection rate of HBV DNA and HBV virus serum marker were compared at week 12, 24, 36, 48 and week 72 (during follow-up visit) .Adverse reactions and drug resistance were also observed.Results (1) Serum ALT normalization rates in all three groups were not statistically significant. (P>0.05) ; (2) In group B, negative conversion ratio of HBeAg and seroconversion rate were 39.67% and 31.59% respectively at week 48, which had significant difference with group A & C (P<0.05) ; (3) In group A, negative conversion ratio of HBeAg and seroconversion rate were 30.29% and 29.27% respectively at week 48, comparing with 6.74% and 5.62% in group C (P<0.05) ; (4) Both group B and C acquired high HBV DNA detection limit at week 12.But at week 48, the drug resistance rate in group C reached 12.21% while it was only 3.23% in group B; (5) During the treatment, some patients had mild leukopenia, but no severe ADR happened.All patients completed their therapy.Conclusion Anti-HBV effect is observed in all three groups but combined use of rh Interferon α-2b and lamivudine has better efficacy than mono-therapy of either interferon or lamivudine.Appropriate extension of the treatment course will help the patients acquire comparatively higher negative conversion ratio and seroconversion rate of HBeAg.Combination therapy of rh interferon α-2b and lamivudine also reduces patients' drug resistance rate.
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Key words:
- interferon Alfa-2b /
- hepatitis B /
- chronic /
- hepatitis B e antigens
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