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PegIFN alpha-2a在停止使用核类模拟剂后减少了HBeAg阴性患者的复发:一项随机对照试验

Fahong Li¹, Lihong Qu², Yanhong Liu³

¹Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Shanghai Institute of Infectious Diseases and Biosecurity, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.

Journal of hepatology

|August 2, 2024

概括

从核同类 (NUC) 疗法转换为基化干扰素α-2a (PegIFN-α-2a),可显著降低乙型肝炎病毒复发率. 这种策略还增加了乙型肝炎表面抗原 (HBsAg) 的损失,而不是仅仅停止NUC.

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:

核类型 (NUC) 停止可以导致乙型肝炎表面抗原 (HBsAg) 清除,但与高病毒性复发率有关.
基化干扰素α-2a (PegIFN-α-2a) 在NUC停止后预防病毒性复发的疗效在很大程度上是未知的.
对于HBeAg阴性慢性乙型肝炎患者,需要一个优化的策略来最大限度地减少NUC撤回后的病毒学复发.

研究的目的:

评估从NUC治疗转换为48周的PegIFN-α-2a疗程对高达96周的病毒学复发率的影响.
为了比较接受PegIFN-α-2a和接受NUC终止的患者之间的病毒学复发率.
在两个治疗臂中评估HBsAg损失率.

主要方法:

一个多中心随机对照试验,涉及180名长期接受NUC治疗的非肝硬化HBeAg负慢性乙型肝炎患者.
患者被随机分配到停止NUC治疗 (n=90) 或接受48周PegIFN-α-2a治疗 (n=90).
随访延长至96周,主要终点是累积病毒学复发率.

主要成果:

与NUC戒断组相比,PegIFN-α-2a组在96周的累积病毒学复发率明显较低 (20.8%对53.6%,p <0.0001).
在停止治疗48周后,干扰素单一治疗组的病毒学复发明显较低 (17.8%对比36.7%,p = 0.007).
干扰素单一治疗组的累积临床复发率较低 (7.8%对20.9%,p = 0.008) 和HBsAg损失率较高 (21.5%对9.0%,p = 0.03).

结论:

从NUC转换为48周的PegIFN-α-2a疗法显著降低了HBeAg阴性慢性乙型肝炎患者的病毒学复发率.
这种策略导致HBsAg损失的比率高于突然NUC停止.
这些发现表明NUC停止的最佳方法,可能改善这些患者的长期结果.

关键词:

在 HBeAg 阴性.慢性乙型肝炎慢性乙型肝炎干扰素α-2a是一种干扰素.随机对照试验是随机对照试验.这是一个复发的复发.停止治疗停止治疗

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