Efficacy of pegylated interferon α-2a in HBe Ag-negative chronic hepatitis B patients and its influencing factors
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摘要: 目的观察聚乙二醇干扰素(PEG-IFN)α-2a治疗HBe Ag阴性慢性乙型肝炎(CHB)患者的疗效及其影响因素。方法收集2009年5月-2012年12月在南方医科大学南方医院感染内科就诊的HBe Ag阴性的CHB患者103例,给予PEG-IFNα-2a 135μg治疗,平均疗程为13个月,治疗后随访48周,在治疗及随访期间每3个月检查肝功能、HBV DNA定量。组间频数比较采用χ2检验,均数比较采用t检验,采用二分类多元Logistic回归法分析疗效的影响因素。结果 103例患者治疗结束时,取得联合应答者84例,联合应答率为81.6%。随访过程中复发33例,复发率为39.3%,治疗后随访1年持续应答患者49例,持续应答率47.6%。经单因素和多因素分析,抗-HBe阳性是唯一的与持续应答相关的独立影响因素(OR=3.69,P=0.013),HBV DNA定量、HBV基因型、前C/BCP区变异、肝脏病理等其他治疗前基线特征与持续应答无相关性。结论 PEG-IFNα-2a治疗HBe Ag阴性CHB能够取得较好的疗效,但复发率较高;抗-HBe阳性患者的持续应答率较高。Abstract: Objective To observe the efficacy of pegylated interferon α-2a(PEG-IFN α-2a) in HBe Ag-negative chronic hepatitis B(CHB) patients and to analyze its influencing factors.Methods One hundred and three HBe Ag-negative CHB patients,who visited Department of Infectious Diseases,Nanfang Hospital,Southern Medical University,from May 2009 to December 2012,were enrolled in this study.The patients were treated with 135 μg of PEG-IFN α-2a for a mean period of 13 months and then followed up for 48 weeks.During treatment and follow-up,alanine aminotransferase and hepatitis B virus(HBV) DNA levels were measured every three months for each patient.The χ2test or t test was used to compare the frequency or means between groups,and binary multivariate logistic regression analysis was performed to determine influencing factors.Results At the end of treatment,eighty-four(81.6%) of the 103 patients achieved a combined response.Among the patients who achieved a combined response,33 patients(39.3%) relapsed during follow-up and 49 patients(47.6%) had a sustained response during follow-up within one year after treatment.Both univariate and multivariate statistical analyses showed that only HBe Ab positivity was an independent factor associated with sustained response(OR = 3.69,P = 0.013).Other baseline characteristics,including HBV DNA load,HBV genotype,pre C / BCP mutation,and liver histopathology,are not associated with the sustained response.Conclusion PEG-IFN α-2a is an effective treatment for HBe Ag-negative CHB,but the relapse rate is high.CHB patients with positive HBe Ab have a higher rate of sustained response.
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Key words:
- hepatitis B,chronic /
- hepatitis B e antigens /
- interferon alfa-2a
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