聚乙二醇干扰素α治疗非活动性HBsAg携带者的疗效

Efficacy of pegylated interferonαmonotherapy in inactive chronic hepatitis B virus carriers

目的观察非活动性HBsAg携带者(IHC)经聚乙二醇干扰素α(Peg-IFN-α)治疗后HBsAg清除率及血清学转换率。方法入组2019年1月至2021年12月就诊于深圳大学第三附属医院肝病门诊的IHC 58例,根据患者治疗意愿分为治疗组(35例)和对照组(23例)。治疗组皮下注射Peg-IFN-α-2a或Peg-IFN-α-2b 180μg/周,疗程为48周。对照组未给予抗病毒治疗。比较两组48周HBsAg清除率及血清学转换率,Logistic回归分析Peg-IFN-α治疗IHC发生HBsAg阴转的影响因素。结果治疗组和对照组平均基线HBsAg水平分别为172.99U/ml和106.22U/ml。治疗48周,治疗组中40%(14/35)的IHC获得HBsAg清除,14.3%(5/35)患者获得HBsAg血清学转换,对照组中未观察到HBsAg的清除和血清学转换。治疗组HBsAg清除率和HBsAg血清学转换率明显高于对照组(P<0.05)。基线HBsAg水平、12周HBsAg降幅及24周HBsAg降幅是影响Peg-IFN-α治疗IHC发生HBsAg清除的独立影响因素。Peg-IFN-α治疗期间未观察到严重不良事件。结论Peg-IFN-α治疗IHC安全有效,提高了IHC的HBsAg阴转率及血清学转换率。

Objective To evaluate the the HBsAg loss and serological conversion rate of pegylated interferon alpha(Peg-IFN-α)treatment in inactive hepatitis B surface antigen carrier(IHC).Method 58 IHC patients,who admitted to the department of liver disease in Luohu People's Hospital from January 2019 to December 2021,were divided into treatment group(35 cases)and control group(23 cases)according to the patient's willings.Treatment groups were subcutaneously administered with Peg-IFN-α-2a or Peg-IFN-α-2b for 180μg/week for 48 weeks.The control group was not given any antiviral treatment.HBsAg clearance and serological conversion rate were compared between the two groups,Logistic regression was used to analyze the factors affecting HBsAg loss in Peg-IFN-αtreatment with IHC.Result The mean baseline HBsAg levels were 172.99U/ml and 106.22U/ml in the treatment and control groups,respectively.For 48 weeks of treatment,loss of HBsAg was obtained in 40%(14/35)of IHC in the treatment group,HBsAg seroconversion in 14.3%(5/35)of IHC,and HBsAg loss and serological conversion were not observed in the control group.The HBsAg loss and HBsAg seroconversion rates were significantly higher than those in the control group(P<0.05).Baseline HBsAg levels and the magnitude of HBsAg decrease at 12 weeks and 24 weeks were independent factors affecting the occurrence of HBsAg clearance in Peg-IFN-αtreated IHC.No serious adverse events occurred during treatment.Conclusion Peg-IFN-αimproves the HBsAg loss and serological conversion rate of IHC and the treatment is safe and effective.