Treatment options in HBeAg-positive chronic hepatitis B patients with a poor response to 24-week interferon monotherapy
- VernacularTitle:HBeAg阳性慢性乙型肝炎患者干扰素治疗24周应答不佳时的治疗方案
- Author:
Xinxin WANG
1
;
Guosheng YUAN
;
Jinglan LAI
;
Nianhuan YANG
;
Hao ZHANG
;
Junjie WANG
;
Yuanping ZHOU
Author Information
1. 南方医科大学南方医院感染内科
- Keywords:
hepatitis B,chronic;
interferon;
nucleos(t) ides;
therapy,combination
- From:
Journal of Southern Medical University
2015;(6):807-811
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy and safety of 4 treatment options for HBeAg-positive chronic hepatitis B (CHB) patients following a suboptimal response to 24-week interferon monotherapy. Methods The data of 193 HBeAg-positive CHB patients with suboptimal response to 24-week interferon monotherapy were collected from Nanfang Hospital between September, 2010 and January, 2013. According to the subsequent treatments, the patients were divided into group A with additional entecavir or adefovir, group B with further interferon monotherapy, group C with conversion to NAs therapy, and group D with direct therapy withdrawal, and the biochemical and virological results at weeks 24, 48 and 72 were analyzed in the 4 groups. Results At week 48, the HBV DNA negative rates and serum alanine aminotransferase (ALT) normalization rates were both significantly higher in group A and C than in group B (P<0.05); in group A, ETV therapy subgroup had a significantly higher HBV DNA negative rate than ADV therapy subgroup at week 48 (90.3% vs 59.5%, χ2=8.255, P=0.004). At week 72, 39.7%(27/68) of the patients in group A achieved HBeAg seroconversion, a rate significantly higher than those in groups B (χ2=4.238, P=0.040) and C (χ2=7.681, P=0.006); the HBV DNA negative rate and ALT normalization rate in group A were 85.3%(58/68) and 86.8%(59/68), respectively, both significantly higher than those in group B (χ2=23.018, P<0.001; χ2=5.987, P=0.014) but comparable to those in group C (P>0.05). In the two subgroups in group A, the HBV DNA negative rate and HBeAg seroconversion rate were both significantly higher in ETV subgroup (χ2=9.823, P=0.002;χ2=5.450, P=0.020). In group D, all the patients remained HBeAg- positive with abnormal ALT levels and high level of HBV DNA. Conclusion For HBeAg-positive CHB patients with suboptimal response to 24- week interferon monotherapy, combined treatment with NAs (especially ETV) and extension of the treatment course can significantly improve the HBeAg seroconversion rates, HBV DNA negative rates, and ALT normalization rates.
