系统性审查与网络元分析:在停止基化干扰素后,持续的乙肝表面抗原清除
Ying Zhang1,2, Xiaoyu Lin1,2, Huizhen Wu3
1Department of Hepatology, Hepatology Research Institute, the First Affiliated Hospital.
European journal of gastroenterology & hepatology
|July 31, 2024
概括
慢性乙型肝炎 (CHB) 的pegylated干扰素 (PEG-IFN) 策略在HBsAg清除方面表现出不同的成功. 将PEG-IFN与特诺福维尔结合使用,似乎对HBsAg血清转化最有效,特别是在基线低的HBsAg水平时.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 病毒学 病毒学
- 免疫学 免疫学 免疫学
背景情况:
- 慢性乙型肝炎 (CHB) 构成了全球重大健康挑战.
- 基化干扰素 (PEG-IFN) 是一种治疗选择,但其在实现持续的乙型肝炎表面抗原 (HBsAg) 清除中的有效性仍在争论中.
- 了解影响治疗后HBsAg清除的因素对于优化CHB管理至关重要.
研究的目的:
- 评估不同PEG-IFN治疗方案对CHB患者持续HBsAg清除的疗效.
- 为了确定影响PEG-IFN停药后持续HBsAg清除的因素.
- 为了比较各种PEG-IFN策略的有效性,包括组合疗法.
主要方法:
- 一个系统的审查和对研究的元分析对PEG-IFN治疗CHB.
- 在PubMed,Embase,Web of Science和Cochrane图书馆的数据库中搜索到2023年6月.
- 分析了53项涉及9338名CHB患者的研究,使用网络元分析和元回归.
主要成果:
- 在PEG-IFN后,每年HBsAg清除率和血清转化率分别为6.9%和4.7%.
- 聚合在5年的持续HBsAg清除率和血清转化率分别为13.0%和7.8%.
- 与诺福维尔结合的PEG-IFN显示HBsAg血清转换的概率最高;较低的基线HBsAg水平与更好的清除相关.
结论:
- 持续的HBsAg清除率在PEG-IFN停止后长达5年的时间内线性增加.
- 低基线HBsAg量化是持续清除的关键预测指标.
- 使用PEG-IFN和诺福维尔的联合治疗可能是实现CHB中持续的HBsAg血清转换的最佳策略.
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