Ultra-Long-term Follow-up of Interferon Alfa Treatment for HBeAg-Positive Chronic Hepatitis B Virus Infection
Ultra-Long-term Follow-up of Interferon Alfa Treatment for HBeAg-Positive Chronic Hepatitis B Virus Infection
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DOI：
10.1016/j.cgh.2020.09.004
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发表时间：
2021-08-14
影响因子：
12.6
通讯作者：
Janssen, Harry L. A.
中科院分区：
文献类型：
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作者：
Choi, Hannah S. J.;van Campenhout, Margo J. H.;Janssen, Harry L. A.
背景和目标：干扰素-α（IFN-α）治疗慢性B（CH B）病毒感染是有限的，并导致相对较高的功能治愈率（HBsAg丢失）比核苷类似物（NA）治疗。在CHB patients.METHODS的超长期随访中，评价了聚乙二醇（PEG）/常规IFN-α治疗对临床结局的影响：纳入了1977-2014年间在三级转诊中心接受（PEG）IFN-α治疗的HBeAg阳性患者。我们查阅了病历，并咨询了市政登记处的病人信息。如果随访数据缺失，则邀请患者在门诊进行单次访视。终点包括血清HBeAg/HBsAg丢失和临床事件发生率，采用寿命表法和人年法分析事件发生率。患者审查后retreatment.RESULTS：研究队列包括267例患者，67%男性，58%白人，中位年龄为32岁。中位随访时间为11.5年。5年和10年HBsAg丢失的累积发生率分别为14%和32%。与HBsAg丢失率较高相关的基线因素为男性、白种人、A基因型、年龄≥ 40岁和肝硬化。HBsAg丢失率在接受短期（24周）治疗的患者之间没有显著差异。HBeAg和HBsAg丢失与临床结局改善显著相关。早期反应（HBeAg丢失）与更多的HBsAg丢失和更好的患者outcomes.CONCLUSIONS：在长期随访中，从一个单一的（PEG）IFN-α过程中观察到HBsAg丢失率很高。它的持续作用表明，IFN-α的作用仍然存在，可能在寻找功能性治愈的新型联合治疗中发挥作用。
BACKGROUND AND AIMS: Interferon-alpha (IFN-alpha) treatment for chronic hepatitis B (CHB) virus infection is finite and leads to relatively higher functional cure rates (HBsAg loss) than nucleo(s)tide analogue (NA) therapy. Effects of pegylated (PEG)/conventional IFN-alpha treatment on clinical outcomes were evaluated in an ultra-long-term follow-up of CHB patients.METHODS: HBeAg-positive patients treated with (PEG)IFN-alpha at a tertiary referral centre between 1977-2014 were included. We reviewed medical charts and consulted the municipal registry for patient information. Patients were invited for a single visit at the outpatient clinic in the case of missing follow-up data. The endpoints included serum HBeAg/HBsAg loss and incidence of clinical events, using life table methods and person-years to analyze the incidence of events. Patients were censored upon retreatment.RESULTS: The study cohort included 267 patients, 67% male, 58% Caucasian, with a median age of 32 years. The median follow-up duration was 11.5 years. The 5 and 10-year cumulative incidence of HBsAg loss were 14% and 32%, respectively. Baseline factors associated with a higher rate of HBsAg loss were male sex, Caucasian race, genotype A, age >= 40 years, and cirrhosis. HBsAg loss rates did not differ significantly between those who received short-term (24 weeks) therapy. Both HBeAg and HBsAg loss were significantly associated with improved clinical outcomes. Early response (HBeAg loss) was associated with more HBsAg loss and better patient outcomes.CONCLUSIONS: During long-term follow-up, high rates of HBsAg loss were observed from a single (PEG)IFN-alpha course. Its persistent effects suggest that a role for IFN-alpha remains, potentially in novel combination therapies in search of a functional cure.