[Impact of liver steatosis on antiviral effects of pegylated interferon-alpha in patients with chronic hepatitis B].
[Impact of liver steatosis on antiviral effects of pegylated interferon-alpha in patients with chronic hepatitis B].
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DOI：
10.3760/cma.j.issn.1007-3418.2012.04.012
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发表时间：
2012-04-01
影响因子：
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通讯作者：
Fan, Jian-gao
中科院分区：
文献类型：
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作者：
Shi, Jun-ping;Lu, Lu;Fan, Jian-gao
目的：探讨肝脂肪变性对聚乙二醇化干扰素- α (PEG-IFNa)治疗慢性乙型肝炎（CHB）患者病毒学反应的影响。方法：96例乙型肝炎e抗原（HBeAg）阳性且活检证实为CHB的初发患者给予PEG-IFNa-2a或PEG-IFNa-2b治疗48周。比较34例脂肪变性患者（n=34）和62例非脂肪变性患者（n=62）的病毒学反应（HBeAg清除率和乙型肝炎病毒（HBV） DNA小于5 log10拷贝/ml）和生化反应（丙氨酸转氨酶（ALT）正常化）。结果：脂肪变性组HBV DNA滴度显著低于非脂肪变性组（6.961.27 vs. 7.541.28 log10 copies/ml; t=2.161， P=0.033）。PEG-IFNa治疗48周后，脂肪变性和非脂肪变性患者的HBeAg血清转化或无法检测到的HBV DNA百分比（小于3 log10拷贝/ml）无显著差异。然而，脂肪变性患者的完全缓解率（病毒学反应加生化反应）明显低于非脂肪变性患者（26.5% vs 48.4%; x =4.373， P=0.037）。在治疗48周后HBV DNA检测不出的45例CHB患者中，7例未达到ALT正常化。非生化反应发生率脂肪变性组明显高于非脂肪变性组（33.3% vs. 6.67%； P=0.032）。结论：肝脂肪变性不影响PEG-IFNa治疗48周的CHB患者的病毒学应答，但影响其生化应答。
OBJECTIVE: To investigate the impact of hepatic steatosis on virologic response in chronic hepatitis B (CHB) patients treated with pegylated interferon-alpha (PEG-IFNa).METHODS: Ninety-six naive patients positive for hepatitis B e antigen (HBeAg) and with biopsy-proven CHB were administered PEG-IFNa-2a or PEG-IFNa-2b for 48 weeks. Virologic response (HBeAg clearance and hepatitis B virus (HBV) DNA less than 5 log10 copies/ml) and biochemical response (alanine transaminase (ALT) normalization) were compared between patients with (n=34) and without (n=62) steatosis.RESULTS: The HBV DNA titer in the steatosis group was significantly lower than that of the non-steatosis group (6.961.27 vs. 7.541.28 log10 copies/ml; t=2.161, P=0.033). After 48 weeks of PEG-IFNa treatments, there was no significant difference in HBeAg seroconversion or the percentage of undetectable HBV DNA (less than 3 log10 copies/ml) between steatosis and non-steatosis patients. However, the steatosis patients presented with a significantly lower complete response rate (virologic response plus biochemical response) compared to non-steatosis patients (26.5% vs. 48.4%; x =4.373, P=0.037). Of the 45 CHB patients with undetectable HBV DNA after 48 weeks of treatment, seven did not achieve ALT normalization. The rate of patients with non-biochemical response was significantly higher in the steatosis group than in the non-steatosis group (33.3% vs. 6.67%; P=0.032).CONCLUSION: Hepatic steatosis does not affect the virologic response, but does affect the biochemical response in CHB patients treated with PEG-IFNa for 48 weeks.