与Peg-IFN结合的NAs对CHB患者的功能治愈的有效性:对RCT的元分析
Yaqin Zhang1, Ziyu Zhang1, Xinxin Li1
1Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
Annals of medicine
|March 4, 2026
概括
与核糖类类似物 (NAs) 和基化干扰素 (Peg-IFN) 联合治疗改善了慢性乙型肝炎 (CHB) 功能治愈率,相比单独使用NAs. 然而,与Peg-IFN单疗相比,它没有任何额外的好处,因为Peg-IFN单疗具有更高的ALT爆发发率.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 病毒学 病毒学
- 药理学 药理学是指药理学的学科.
背景情况:
- 慢性乙型肝炎 (CHB) 治疗的目标是功能治愈.
- 对核糖类类似物 (NA) 和基化干扰素 (Peg-IFN) 的联合治疗进行评估对于CHB管理至关重要.
- 在治疗结束 (EOT) 和随访结束 (EOF) 时评估治疗疗效是至关重要的.
研究的目的:
- 为了评估NA和Peg-IFN联合治疗与单一治疗对CHB功能治愈的疗效.
- 为了比较EOT和EOF的HBsAg清除率和血清转化率.
- 评估组合治疗与单一治疗的安全性,包括ALT爆发.
主要方法:
- 在PubMed,Embase和Web of Science的系统文献搜索,截至2025年3月15日.
- 包括16个随机对照试验 (RCT),比较组合治疗与单一治疗.
- 对HBsAg清除率和血清转化率等疗效结果的元分析,以及对ALT爆发等安全结果的元分析.
主要成果:
- 与单独的NA相比,组合疗法显著改善了EOT和EOF的HBsAg清除率和血清转化率.
- 在组合治疗和Peg-IFN单疗之间没有观察到HBsAg清除或血清转换的显著差异.
- 与组合疗法相比,Peg-IFN单一治疗显示ALT爆发的发生率更高.
结论:
- 与核酸相似物相结合的基化干扰素与单独的核酸相似物相比,在CHB患者中显著提高了功能治愈率.
- 组合疗法在实现功能治愈方面没有比基化干扰素单一疗法提供额外的好处.
- 单独治疗佩吉莱特干扰素与ALT爆发的风险比组合治疗更高.
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