Effects of nucleos(t)ide analogs on hepatitis B surface antigen reduction with interferon-lambda 3 induction in chronic hepatitis B patients
Effects of nucleos(t)ide analogs on hepatitis B surface antigen reduction with interferon-lambda 3 induction in chronic hepatitis B patients
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DOI：
10.1111/hepr.13768
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发表时间：
2022-04-12
影响因子：
4.2
通讯作者：
Sakamoto，Naoya
中科院分区：
文献类型：
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作者：
Umemura，Machiko;Ogawa，Koji;Sakamoto，Naoya
背景和目的核苷（酸）类似物（NA）对乙型肝炎表面抗原（HBsAg）减少和干扰素-λ3（IFN-λ3）诱导的益处尚不清楚。本研究旨在探讨 NAs 对慢性乙型肝炎 (CHB) 患者 HBsAg 降低的影响以及与血清 IFN-λ3 水平的关系。方法总共 91 名患者 [51 名接受核苷类似物恩替卡韦水合物 (ETV) 治疗，40 名接受核苷酸类似物阿德福韦酯 (ADV) 或富马酸替诺福韦二吡呋酯 (TDF) 治疗] 临床上明显的慢性乙型肝炎（慢性肝炎，57 例；肝硬化，34 例）被纳入本研究。在治疗开始前以及治疗后 1 年、3 年和 5 年测量接受 ETV 和 ADV/TDF 的患者的血清 IFN-λ3 水平。 结果 ETV 组和 ADV/TDF 组中血清 HBsAg 水平从基线到第 5 年的变化（平均值±标准差）分别为 -0.38 ± 0.46 和 -0.84 ± 0.64 log10IU/ml （p=0.0004）。治疗期间，ADV/TDF 组的血清 IFN-λ3 水平高于 ETV 组（p<0.001）。第 48 周时，ADV/TDF 组的血清 IFN-λ3 水平与 HBsAg 下降呈负相关（r= -0.386，p= 0.038）。核苷酸类似物 (ADV/TDF) 治疗与 1 年时 -0.3 log HBsAg 下降、3 年时 -0.5 log HBsAg 下降和 5 年时 -0.8 log HBsAg 下降相关。 NAs治疗后 结论：与核苷类似物 (ETV) 相比，核苷酸类似物 (ADV/TDF) 治疗在 IFN-λ3 诱导的同时，更能降低 HBsAg 水平。
Background & AimsBenefits of nucleos(t)ide analogs (NAs) on hepatitis B surface antigen (HBsAg) reduction and interferon‐lambda3 (IFN‐λ3) induction are still not known. This study aimed to investigate the effects of NAs on HBsAg reduction and association with serum IFN‐λ3 levels in chronic hepatitis B (CHB) patients.MethodsA total of 91 patients [51 treated with nucleoside analog entecavir hydrate (ETV) and 40 treated with nucleotide analog adefovir dipivoxil (ADV) or tenofovir disoproxil fumarate (TDF)] with clinically evident CHB (chronic hepatitis, 57; liver cirrhosis, 34) were enrolled in this study. Serum IFN‐λ3 levels among patients receiving ETV and ADV/TDF were measured before the initiation of therapy and 1, 3, and 5 years post‐therapy.ResultsThe change (mean ± standard deviation) in serum HBsAg levels from baseline to year five was −0.38 ± 0.46 and −0.84 ± 0.64 log10IU/ml in ETV and ADV/TDF groups, respectively (p= 0.0004). Higher serum IFN‐λ3 levels were observed in ADV/TDF group compared with ETV group during treatment (p< 0.001). Serum IFN‐λ3 levels showed negative correlation with HBsAg reduction in ADV/TDF group (r= −0.386,p= 0.038) at week 48. Nucleotide analogs (ADV/TDF) treatment has associated factors with −0.3 log HBsAg decline at 1 year, −0.5 log HBsAg decline at 3 years, and −0.8 log HBsAg decline at 5 years after NAs treatment on multivariate analysis.ConclusionsNucleotide analog (ADV/TDF) treatment reduced HBsAg levels greater compared with nucleoside analog (ETV) in parallel with IFN‐λ3 induction.