Influencing factors of efficacy of nucleos(t)ide analogues and Peg IFNα-2a combination therapy for patients with chronic hepatitis B
10.3760/cma.j.issn.1674-2397.2024.02.005
- VernacularTitle:核苷（酸）类似物联合聚乙二醇干扰素治疗慢性乙型肝炎实现临床治愈的影响因素分析
- Author:
Xiaoyu HU
1
;
Jia JI
;
Lanjuan LI
Author Information
1. 浙江大学医学院附属第一医院 传染病重症诊治全国重点实验室，杭州 310003
- Keywords:
Chronic hepatitis B;
Nucleos（t）ide analogues（NAs）;
Peg IFNα-2a;
Clinical cure
- From:
Chinese Journal of Clinical Infectious Diseases
2024;17(2):126-132
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the influencing factors of efficacy of combination therapy of nucleos（t）ide analogues（NAs）with pegylated interferon α-2a（Peg IFNα-2a）for patients with chronic hepatitis B（CHB）.Methods:The clinical data of 141 CHB patients receiving combination therapy of NAs and Peg IFNα-2a for ≥48 weeks in the First Affiliated Hospital of Zhejiang University School of Medicine from January 1，2013 to December 1，2023 was retrospectively analyzed. Patients were divided into clinical cure group（ n=45）and non-clinical cure group（ n=96）. Multivariate Logistic regression analysis was used to analyze the influencing factors of clinical cure. Results:Multivariate Logistic regression analysis showed that baseline HBsAg <1 500 IU/mL（ OR=0.160，95% CI 0.049-0.522， P=0.002），a decrease by >1 lg IU/mL in HBsAg at week 48 compared to the baseline level（ OR=0.114，95% CI 0.027-0.484， P=0.003），and sequential combination therapy（ OR=0.351，95% CI 0.128-0.960， P=0.041）were independent predicting factors for the efficacy of combination therapy of NAs and Peg IFNα-2a in CHB patients. Conclusions:The study indicates that the efficacy of the sequential combination therapy is superior to that of the treatment-na?ve therapy，and patients with baseline HBsAg<1 500 IU/mL is more likely to achieve clinical cure than those with higher baseline levels. A primary course of 48 weeks was recommended，with the possibility of an extension of the course by evaluating the degree of HBsAg decline at 48 weeks.
