Reduction of Hepatitis B Surface Antigen More Pronounced In Pegylated Interferon Alpha Therapy Combined With Nucleotide Analogues Than Nucleoside Analogues In Chronic Hepatitis B Patients
Reduction of Hepatitis B Surface Antigen More Pronounced In Pegylated Interferon Alpha Therapy Combined With Nucleotide Analogues Than Nucleoside Analogues In Chronic Hepatitis B Patients
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在慢性乙型肝炎患者中，聚乙二醇化干扰素α联合核苷酸类似物治疗比核苷类似物更明显地减少乙型肝炎表面抗原
DOI：
10.21203/rs.3.rs-510467/v1
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发表时间：
2021-06
影响因子：
2.7
通讯作者：
Jiming Zhang
中科院分区：
文献类型：
--
作者：
Yiran Xie;Haoxiang Zhu;Yifei Guo;Zhenxuan Ma;Xun Qi;Feifei Yang;Richeng Mao;Jiming Zhang
背景：由于其免疫调节功能，核苷酸类似物（NT）单一疗法在降低乙型肝炎表面抗原（HBsAg）方面可能比核苷类似物（NS）具有更大的效果。然而，与聚乙二醇化干扰素 α (PegIFNα) 联合使用时，这种优势仍然未知。该研究旨在探讨 NTs 与 PegIFNα 联合治疗中是否比 NSs 具有更强的抗病毒作用。方法：回顾性招募接受 PegIFNα 加核苷（酸）类似物（NA）治疗的慢性乙型肝炎（CHB）患者。分析了 48 周时乙型肝炎表面抗原 (HBsAg) 减少 > 1 log10 IU/mL 的疗效和预测因素。结果：共纳入95例患者，包括PegIFNα加NSs组和PegIFNα加NTs组。进行倾向评分匹配（PSM）。即使在 PSM 后，PegIFNα + NTs 组的 HBsAg 降低幅度更大（−3.48 vs -2.33 log10 IU/mL，P = 0.038），并且 HBsAg 降低 > 1 log10 IU/mL 的患者比例较高（100.0% vs 72.2%，P = 0.003）。然而，HBsAg和乙型肝炎e抗原（HBeAg）丢失率、HBeAg血清转换率、HBeAg和乙型肝炎病毒（HBV）DNA下降程度、HBV DNA不可检测率和丙氨酸转氨酶（ALT）正常化率没有显着差异。较高的血小板计数（OR = 1.043，95%CI = 1.002–1.085）和 PegIFNα 加 NT（OR = 77.861，95%CI = 3.923–1545.273）是 48 周时 HBsAg 降低 > 1 log10 IU/mL 的独立预测因子。结论：本研究表明 PegIFNα 联合 NT 导致更多 HBsAg 降低。
Background: Nucleotide analogues (NTs) monotherapy may have a greater effect on reducing hepatitis B surface antigen (HBsAg) than nucleoside analogues (NSs) due to their immunomodulatory function. However, this superiority remains unknown when combined with pegylated interferon α (PegIFNα). The study aimed to explore whether NTs have greater antiviral effects than NSs in combination therapy with PegIFNα. Methods: Chronic hepatitis B (CHB) patients treated with PegIFNα plus nucleos(t)ide analogues (NAs) were retrospectively recruited. Efficacy and the predictors of hepatitis B surface antigen (HBsAg) reduction > 1 log10 IU/mL at 48 weeks were analyzed. Results: A total of 95 patients were investigated, including in PegIFNα plus NSs group and in PegIFNα plus NTs group. Propensity score matching (PSM) was performed. The PegIFNα + NTs group had a greater reduction of HBsAg (−3.48 vs −2.33 log10 IU/mL, P = 0.038) and a higher proportion of patients with HBsAg reduction > 1 log10 IU/mL (100.0% vs 72.2%, P =0.003) even after PSM. However, HBsAg and hepatitis B e-antigen (HBeAg) loss rates, HBeAg seroconversion rates, degree of HBeAg and hepatitis B virus (HBV) DNA decline, HBV DNA undetectable rates, and alanine aminotransferase (ALT) normalization rates showed no significant differences. Higher platelet counts (OR = 1.043, 95%CI = 1.002–1.085) and PegIFNα plus NTs (OR = 77.861, 95%CI = 3.923–1545.273) were independent predictors for HBsAg reduction > 1 log10 IU/mL at 48 weeks. Conclusion: This study suggests that PegIFNα plus NTs led to more HBsAg reduction.
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DOI：
10.1016/j.meegid.2019.104101
发表时间：
2020-03
期刊：
Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases
影响因子：
--
作者：
F. Xiong;Xuli Bao;Na Gu;Jia Guo;Jinhuan Wang;Yanpin Ma;Lele Yu;Yao Gao;Bingqin Tan;Jun Lu
通讯作者：
F. Xiong;Xuli Bao;Na Gu;Jia Guo;Jinhuan Wang;Yanpin Ma;Lele Yu;Yao Gao;Bingqin Tan;Jun Lu
影响因子：
25.7
作者：
Ning, Qin;Han, Meifang;Zhao, Mianzhi
通讯作者：
Zhao, Mianzhi
影响因子：
29.4
作者：
Yip, Terry Cheuk-Fung;Wong, Vincent Wai-Sun;Wong, Grace Lai-Hung
通讯作者：
Wong, Grace Lai-Hung
影响因子：
13.5
作者：
Bolen, Christopher R.;Ding, Siyuan;Robek, Michael D.;Kleinstein, Steven H.
通讯作者：
Kleinstein, Steven H.
影响因子：
8.8
作者：
Kittner, Jens M.;Sprinzl, Martin F.;Schuchmann, Marcus
通讯作者：
Schuchmann, Marcus