回顾性分析聚乙二醇干扰素ɑ治疗慢性乙型肝炎HBsAg清除的预测因素分析

Retrospective Analysis of Predictors of HBsAg Clearance in the Treatment of Chronic Hepatitis B with Pegylated Interferon Alpha

目的本研究旨在分析聚乙二醇干扰素α(PEG-IFNα)治疗e抗原(HBeAg)阴性慢性乙型肝炎(CHB)患者48周后表面抗原(HBsAg)清除的预测因素。方法回顾性分析2017年1月~2021年8月于徐州医科大学附属医院就诊,使用PEG-IFNα治疗的HBeAg阴性CHB患者124例。分析12、24、36、48周HBV DNA应答率和HBsAg清除率等。以69例完成48周治疗的患者分析48周HBsAg清除的预测因素,按照48周HBsAg清除情况分为清除组(n=15)和未清除组(n=54)。结果核苷酸类似物(NAs)经治,基线HBV DNA低于最小检测值,基线、12周、24周HBsAg定量,基线HBsAg/12周HBsAg定量,24周ALT水平与48周HBsAg清除有关。其中基线、12周、24周HBsAg定量,基线HBsAg/12周HBsAg及24周ALT水平是48周HBsAg清除的独立预测因素,24周HBsAg定量预测价值最优。结论基线及治疗中HBsAg定量、24周ALT水平可以预测HBeAg阴性CHB患者使用PEG-IFNα治疗48周后HBsAg清除。

Objective To analyze the predictors of hepatitis B surface antigen(HBsAg)clearance after 48 weeks of pegylated interferon alpha(PEG-IFNα)therapy for hepatitis envelope antigen(HBeAg)negative chronic hepatitis B.Methods Totally 124 patients who underwent PEG-IFNαtreatment for HBeAg-negative CHB in the Affiliated Hospital of Xuzhou Medical University from January 2017 to August 2021 were enrolled.The HBV DNA response rates and HBsAg clearance rates at week 12,week 24,week 36 and week 48 were Analyzed.69 patients who completed PEG-IFNαtreatment for 48 weeks were selected to analyze the predictors of HBsAg clearance at week 48.According to whether the HBsAg has been cleared at week 48,the 69 patients were divided the HBsAg cleared group(n=15)and the HBsAg uncleared group(n=54).Results After nucleotide analogues(NAs)being treated,HBV DNA was lower than the minimum detectable value,and HBsAg quantification at baseline,week 12,week 24,the ratio between baseline HBsAg quantification and HBsAg quantification at week 12 and ALT level at week 24 were associated with HBsAg clearance at week 48.In addition,HBsAg quantification at baseline,at week 12,at week 24,the ratio between baseline HBsAg quantification and HBsAg quantification at week 12 and ALT level at week 24 were independent predictors of HBsAg clearanc at week 48,and all of them have goog predictive value,the HBsAg quantification at week 24 had the best predictive value.Conclusion HBsAg quantification at baseline and on treatment,ALT level at week 24 can predict HBsAg clearance after 48 weeks of PEG-IFNαtreatment in HBeAg-negative CHB patients.