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将基化干扰素-α 添加到核胺类比物中,可以改善慢性乙型肝炎患者的HBsAg清除率,而这种患者患有较低水平的病毒性病

Lilin Wang¹, Junfeng Lu¹, Dan Liu¹

¹The First Department of Liver Disease Center, Beijing You'an Hospital, Capital Medical University, Beijing, China.

Frontiers in medicine

|September 8, 2025

概括

结合治疗与核胺类同类 (NAs) 加上基化干扰素-α (pegIFN-α) 在慢性乙型肝炎 (CHB) 患者中改善了HBsAg清除. 这种方法可以提高治疗效率超出NA单一治疗.

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) 中的低水平病毒病 (LLV) 与肝纤维化进展和肝细胞癌风险有关.
核胺类比物 (NA) 是标准的CHB治疗,但实现完全的病毒抑制和HBsAg清除仍然具有挑战性.

研究的目的:

为了比较NA疗法的疗效与与NA和 pegylated 干扰素-alfa (pegIFN-α) 结合疗法的疗效,在因特卡维尔 (ETV) 治疗的患有LLV的CHB患者中.
评估对乙型肝炎表面抗原 (HBsAg) 水平和完整病毒学反应 (CVR) 的影响.

主要方法:

回顾性队列研究包括127名接受ETV治疗的CHB患者LLV.
患者被分为两个组:NA组 (切换为tenofovir 胺酸) 和NA+IFN组 (添加pegIFN-α).
在48周内,各组之间的HBV标志物和CVR率的比较.

主要成果:

与NA组相比,NA+IFN组在24周的HBsAg水平下降显著更大,并且在48周的HBsAg清除率更高.
具体来说,在48周,NA+IFN组的HBsAg清除率为8.9%,而NA组的清除率为0% (P=0.017).
48周的CVR率在两组之间是可比的 (66.7%在NA+IFN和68.4%在NA,P=0.836).

结论:

在接受ETV治疗的CHB患者中,添加NA疗法中的pegIFN-α显著提高了HBsAg清除.
联合治疗可能在降低HBsAg水平方面具有优势,HBsAg水平是CHB进展的关键标志物.
虽然CVR率相似,但改善的HBsAg动力学表明组合治疗的潜在长期益处.

关键词:

在HBsAg清除过程中,慢性乙型肝炎慢性乙型肝炎低水平的病毒性血清.基化干扰素-α.诺福维尔阿拉芬胺胺烟酸

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