慢性乙型肝炎抗病毒治疗对乙型肝炎病毒X蛋白表达的影响

Effect of antiviral treatment for chronic hepatitis B patients on hepatitis B virus X protein expression

目的:观察慢性乙型肝炎抗病毒治疗对乙型肝炎病毒X蛋白(hepatitis B virus X protein,HBx)表达的影响。方法:选取96例慢性乙肝初治患者,其中HBe Ag阳性56例,HBe Ag阴性40例。两组患者组内平均分为聚乙二醇干扰素α-2a治疗组(干扰素组)和恩替卡韦治疗组。聚乙二醇干扰素(180μg,每周1次)疗程48周,恩替卡韦(0.5 mg,1次/d)疗程96周。应用蛋白质印迹法检测治疗前和治疗后48周、96周3个时点各组病例肝组织内HBx的表达。结果:所有患者治疗前肝组织HBx均为阳性表达。治疗后48周,HBe Ag阳性干扰素组、恩替卡韦组,以及HBe Ag阴性干扰素组、恩替卡韦组HBx阴性表达率别为73.08%(19/26)、40.74%(11/27)、42.11%(8/19)、45.00%(9/20)。治疗后各组HBx阴性表达率均明显高于治疗前(P均为0.00)。HBe Ag阳性干扰素组HBx阴性表达率明显高于其他3组(P均<0.05)。恩替卡韦治疗96周时,HBe Ag阳性组和HBe Ag阴性组HBx阴性表达率无明显差异[48.15%(13/27)、55.00%(11/20)],和48周时比较也无明显差异(P均>0.05)。结论:干扰素用于HBe Ag阳性的慢性乙肝患者,其抑制X蛋白表达的效果明显优于恩替卡韦。

Objective： To investigate the variation of hepatitis B virus X （HBx） protein expression during antiviral treatment for chronic hepatitis B （CHB） patients. Methods ： Fifty-six naive CHB patients with HBeAg-positive and 40 naive CHB patients with HBeAg-negative were divided randomly into the pegylated-interferon （Peg-IFN） therapy group receiving Peg-IFNα-2a （180 μg/week） for 48 weeks and entecavir therapy group receiving entecavir （0.5 mg/d） for 96 weeks. All patients were tested hepatic tis- sue for the HBx protein expression levels by Western-blotting method at treatment weeks 0, 48, and 96. Results： At week 0, The HBx protein expression of all patients were positive. At week 48, the rates of the HBx protein negative expression in Peg-IFNα-2a therapy group and entecavir therapy group with HBeAg-positive, and in Peg-IFNα-2a therapy group and entecavir therapy group with HBeAg-negative, were 73.08% （19/26） ,40.74% （ 11/27 ）, 42. 11% （ 8/19 ）, 45.00% （ 9/20）, and were significantly different from at week 0（all P values were 0.00） ; then, the rate in Peg-IFNα-2a therapy group was significant difference from others three groups （all P values were less than 0.05）. At week 96, the rates of the HBx protein negative expression had no significant difference in entecavir therapy group with HBeAgpositive and with HBeAg-negative [ 48.15% （13/27）, 55.00% （11/20 ）] ; and compared at week 48, the results were similar （ All P values were greater than 0.05 ）. Conclusion ： Compared to entecavir,Peg-IFN was more potent to suppress the HBx protein expression.