聚乙二醇干扰素α短期治疗HBsAg水平极低的非活动性HBsAg携带者的疗效观察

摘要/Abstract

摘要： 目的观察HBsAg水平极低的非活动性HBsAg携带者(Inactive hepatitis B surface antigen carriers, IHC)经短期聚乙二醇干扰素α-2b(Peg IFNα-2b)治疗后的HBsAg清除率。方法自2017年4月至2018年12月,共38例IHC就诊于厦门长庚医院, 既往未进行抗病毒治疗,且HBsAg水平均小于15 IU/mL。根据患者治疗意愿分为Peg IFNα治疗组(12例)或对照组(26例)。治疗组皮下注射Peg IFNα-2b 180 μg/周,疗程为24周。对照组未给予抗病毒治疗,中位随访55.7(25.3, 79.2)周。运用卡方检验比较两组HBsAg的清除率和血清学转换率的差异,运用logistic回归分析基线特征、Peg IFNα-2b治疗与HBsAg清除间的相关性。结果 24周时,PegIFNα治疗组中83.3%(10/12)IHC获得HBsAg清除,41.6%(5/12)获得HBsAg血清学转换,对照组中有7.7%(2/26)IHC获得HBsAg清除,无一例发生HBsAg血清学转换,Peg IFNα治疗组的HBsAg清除率和HBsAg血清学转换率显著高于对照组(P<0.05)。Peg IFNα-2b治疗可增加IHC的HBsAg清除率(OR=60.00, 95%CI: 7.39~487.14)。结论 Peg IFNα-2b短期治疗HBsAg水平极低的IHC可以提高HBsAg清除率和HBsAg血清学转换率。

关键词: 非活动性HBsAg携带者, 聚乙二醇干扰素α, 慢性乙型肝炎, HBsAg水平极低, HBsAg清除, 临床治愈

Abstract: Objective HBsAg loss represents clinical cure of hepatitis B. The aim of the present study was to investigate the HBsAg loss rate in inactive hepatitis B surface antigen carriers (IHCs) with extremely low HBsAg levels after peg-interferon α-2b (Peg-IFNα) short-term treatment. Methods Thirty-eight cases of IHCs were included in this study. They were treatment-nave and the average baseline HBsAg level were less than 15 IU/mL. According to the patients' willingness, they were divided into Peg-IFNα treatment group (N=12 cases) or control group (N=26 cases). The Peg-IFNα treatment group was subcutaneously injected with 180 μg/week of Peg-IFNα-2b for 24 weeks. The control group were followed up without treatment for a median of 55.7 (25.3±79.2) weeks. SPSS 25.0 software was used for statistical analysis., Chi-square test was used to compare the difference in HBsAg loss rate and HBsAg seroconversion rate between the two groups. Logistic regression was used to analyze the correlation between baseline characteristics, Peg-IFNα treatment and HBsAg loss. Results At 24 weeks, 83.3% (N=10) IHCs in the Peg-IFNα treatment group achieved HBsAg loss and 41.6% (N=5) IHCs achieved HBsAg seroconversion. 7.7% (N=2) IHCs in the control group had HBsAg loss and HBsAg seroconversion rate was 0. The HBsAg loss rate and HBsAg seroconversion rate in Peg-IFNα treatment group were statistically higher than that of the control group (P<0.05). By univariate analysis it was found that Peg-IFNα treatment significantly increased HBsAg clearance of IHCs (OR=60.00, 95% CI: 7.39 - 487.14). Conclusion Peg-IFNα short-term treatment for IHCs with extremely low HBsAg levels may significantly improve HBsAg loss rate and HBsAg seroconversion rate.

Key words: Inactive hepatitis B surface antigen carriers, Peg-interferon α-2b, Chronic hepatitis B, Extremely low HBsAg levels, HBsAg loss, Clinical cure

赵海东, 陈灵峰, 林巧欣, 李艺芳. 聚乙二醇干扰素α短期治疗HBsAg水平极低的非活动性HBsAg携带者的疗效观察[J]. 肝脏, 2020, 25(9): 937-939.

ZHAO Hai-dong, CHEN Ling-feng, LIN Qiao-xin, LI Yi-fang. The efficacy of short-term treatment with Peg-interferon α for inactive hepatitis B surface antigen carriers with extremely low HBsAg levels[J]. Chinese Hepatolgy, 2020, 25(9): 937-939.

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