Interferon alpha treatment leads to a high rate of hepatitis B surface antigen seroconversion in Chinese children with chronic hepatitis B
Interferon alpha treatment leads to a high rate of hepatitis B surface antigen seroconversion in Chinese children with chronic hepatitis B
复制标题
干扰素α治疗导致中国慢性乙型肝炎儿童乙型肝炎表面抗原血清转换率较高
DOI：
10.1111/jvh.13165
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发表时间：
2019-07-01
影响因子：
2.5
通讯作者：
Li, Feng
中科院分区：
文献类型：
--
作者：
Fan, Huimin;Lin, Luping;Li, Feng
尽管预防母婴传播的计划取得了巨大成功，但儿童慢性乙型肝炎病毒 (HBV) 感染 (CHB) 仍然是一个公共卫生挑战。特别是中国儿童慢性乙型肝炎多为垂直传播，与其他国家和地区报道的常见感染途径不同。这种情况导致中国成人慢性乙型肝炎的高流行率。因此，成功治疗慢性乙型肝炎儿童将预防成年后期发展为晚期肝病。然而，目前儿童慢性乙型肝炎的临床治疗指南尚未达成共识。在这项研究中，我们评估了干扰素 α (IFNa) 治疗中国慢性乙型肝炎儿童的潜力。本回顾性研究共纳入 41 名 3-17 岁慢性乙型肝炎患者：其中 21 名患者接受聚乙二醇化 (PEG)-IFNa 治疗，20 名未接受治疗的患者作为对照组。 PEG-IFNa治疗组的HBV DNA抑制率、乙型肝炎e抗原（HBeAg）清除率和乙型肝炎表面抗原（HBsAg）清除率显着高于对照组（48周时P < 0.05）。出乎意料的是，PEG-IFNa 治疗实现了高 HBsAb 产生率，远远超过了有记录的 PEG-IFNa 治疗 CHB 成人的临床结果。进一步分析显示，与青少年（10-17 岁）相比，年龄较小的儿童（3-6 岁）对 PEG-IFNa 治疗在短治疗周期内达到 HBsAb 保护水平的反应更敏感。总体而言，这些结果表明儿童的免疫系统可能保留有 PEG-IFNa 介导的机制来完全控制 HBV，这有助于设计治疗 CHB 患者的新策略。
Chronic hepatitis B virus (HBV) infection (CHB) in children remains a public health challenge despite significant success in programme is established to prevent mother-to-child transmission. In particular, CHB in Chinese children are mostly acquired through vertical transmission, which differs from the common infection route reported in other countries and regions. This situation has resulted in a high endemic prevalence of CHB in Chinese adults. Thus, successful treatment of children with CHB will prevent the development of advanced liver diseases in late adulthood. However, there is still no consensus on the clinical guideline to treat paediatric CHB. In this study, we evaluated the potential of interferon alpha (IFNa) treatment for Chinese children with CHB. A total of 41 patients with CHB aged 3-17 years were enrolled in this retrospective study: 21 patients were treated with pegylated (PEG)-IFNa and 20 patients without treatment served as the control group. The rates of HBV DNA suppression, hepatitis B e antigen (HBeAg) clearance and hepatitis B surface antigen (HBsAg) clearance were significantly higher in the PEG-IFNa treatment group than in the control group (P < 0.05 at 48 weeks). Unexpectedly, PEG-IFNa treatment achieved a high rate of HBsAb production, far exceeding the clinical outcome in documented PEG-IFNa-treated CHB adults. Further analysis revealed that younger children (3-6 years old) were more responsive to PEG-IFNa treatment with respect to achieving a protective level of HBsAb in a short treatment cycle than adolescents (10-17 years old). Overall, these results indicate that the immune system of children might have a preserved PEG-IFNa-mediated mechanism to completely control HBV, which can help to design new strategies to treat CHB patients.