Clinical effect and influencing factors of pegylated interferon alfa-2a and entecavir monotherapy among children with HBeAg-positive chronic hepatitis B based on a real-world study
10.3760/cma.j.cn501113-20210225-00094
- VernacularTitle:基于真实世界的聚乙二醇干扰素α-2a和恩替卡韦单药治疗HBeAg阳性慢性乙型肝炎儿童的效果及其影响因素
- Author:
Huimin WANG
1
;
Yingzhi ZHOU
;
Yunan CHANG
;
Yi HE
;
Xiaorong PENG
;
Peng HU
;
Hong REN
;
Hongmei XU
Author Information
1. 重庆医科大学附属儿童医院感染科 国家儿童健康与疾病临床医学研究中心 儿童发育疾病研究教育部重点实验室 儿科学重庆市重点实验室，重庆 400014
- Keywords:
Children;
Chronic hepatitis B;
Antiviral therapy;
Pegylated interferon α-2a;
Entecavir
- From:
Chinese Journal of Hepatology
2022;30(10):1056-1062
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the efficacy, safety, and influencing factors among children with hepatitis B virus e antigen (HBeAg)-positive chronic hepatitis B (CHB) who received short-term therapy with pegylated interferon alfa-2a (Peg-IFNα-2a) or continuous therapy with entecavir (ETV).Methods:Quantitative data were compared using analysis of variance to compare the differences between groups. Enumeration data were compared by χ2 test (or Fisher's exact test). Univariate and multivariate logistic regressions were used to analyze the influencing factors. Results:Peg-IFNα-2a, ETV, and untreated group had HBsAg clearance rates of 46.2%, 5.3%, and 0 after 52 weeks of therapy, respectively. HBsAg clearance in the patients' group with Peg-IFNα-2a and ETV was all accompanied by anti-HBS positive conversion, and the difference was statistically significant ( χ2=13.616, P=0.001). Peg-IFNα-2a group was followed-up for 104 weeks. Peg-IFNα-2a, ETV, and the untreated group had HBsAg clearance rates of 46.2%, 10.5%, and 0%, respectively, and the differences were statistically significant ( χ2=11.056, P=0.004). Only one of the two children with HBsAg clearance in the ETV group had achieved anti-HBs antibodies, and the difference was statistically significant ( χ2=13.616, P=0.001). Univariate and multivariate logistic regression analysis showed that HBsAg clearance was associated with age and antiviral therapy. During treatment, adverse events such as fever ( n=4, 30.8%), rash ( n=4, 30.8%), fatigue ( n=1, 7.7%), leukopenia ( n=7, 53.8%), arthritis ( n=1, 7.7%), and alopecia ( n=3, 23.1%) were observed in the Peg-IFNα-2a group, while none were observed in the ETV group. Conclusion:Peg-IFNα-2a antiviral therapy produced higher HBsAg clearance than ETV in five-year-old and younger children with HBeAg-positive CHB, while ETV had fewer adverse events and was safer than Peg-IFNα-2a.
