干扰素早期应答不佳的HBeAg阳性慢性乙型肝炎患者序贯策略的研究

Study of sequential strategy for hepatitis B e antigen （HBeAg） positive chronic hepatitis B （CHB） patients with suboptimal early response to Peg- interferon-α

目的探讨聚乙二醇干扰素-α（Peg-IFN-α）早期应答不佳的HBeAg阳性慢性乙肝患者的序贯治疗方案。方法观察组选取HBeAg阳性慢性乙型肝炎（CHB）初治且使用Peg—IFN—α12—24周后HBsAg〉20000IU／mL的患者，对照组则选取初治HBeAg阳性、基线HBsAg〉20000IU／mL的患者。两组均口服恩替卡韦，每12周检测HBVDNA及HBV病毒学标志物。结果观察组43例，对照组52例。疗程48周、96周时，观察组HBeAg血清学转换率分别为23．3％、30．2％，对照组则分别为23．1％、28．8％，两组差异无统计学意义（P=0．98，0．88）。两组疗程48周的血清HBsAg水平均明显下降。结论干扰素早期应答不佳的患者序贯ETV治疗是可选方案。

Objective To investigate the efficacy of entecavir （ETV） sequential therapy in the treatment of hepatitis B e antigen（HBeAg） positive chronic hepatitis B （CHB） patients with suboptimal early response to Peg- interferon -α（ Peg - IFN - α）. Methods The cases of HBeAg - positive CHB who were treated with Peg - IFN - a for 12 to 24 weeks and serum HBsAg 〉 20 000 IU/mL were enrolled into observation group. Treatment naive HBeAg positive CHB with serum HBsAg 〉 20 000IU/mL were enrolled into control group. Both two groups received ETV for 96 weeks. Hepatitis B virus （HBV） virological and serological data were collected every 12 weeks. Results At the end of 48 - week and 96 - week, the rates of HBeAg seroconversion in the observation group were 23.3 % （ 10/43 ）, 30.2% （ 13/43 ）, respectively, which in the control group were 23.1% （12/52） ,28.8% （ 15/52）, respectively. The HBsAg decline at 24 - week was observed in both two groups. Conclusion Sequential strategy for patients with suboptimal early response to IFN is preferable.