Optimal therapy for patients with HBeAg positive chronic hepatitis B who have poor response to interferon α
10.3760/cma.j.issn.1674-2397.2014.01.009
- VernacularTitle:干扰素α治疗HBeAg阳性慢性乙型肝炎应答不佳的优化疗效研究
- Author:
Qi SHEN
;
Zhan ZHANG
;
Yong WU
- Publication Type:Journal Article
- Keywords:
Hepatitis B,chronic;
Interferon alpha;
Adefovir dipivoxil;
Tebivudine
- From:
Chinese Journal of Clinical Infectious Diseases
2014;7(1):45-48
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the efficacy of interferon alpha (IFNα) plus adefovir dipivoxil (ADV) and tebivudine (LdT) monotherapy for patients with HBeAg positive chronic hepatitis B (CHB) who have poor response to IFNα treatment.Methods A total of 86 HBeAg positive CHB patients admitted to the Sixth People' s Hospital of Shaoxing during February 2010 and April 2013 were enrolled in the study.All the patients received IFNα monotherapy for 24 weeks and had poor responses.The patients were voluntarily divided into three groups:IFNα monotherapy group (n =21),IFNα plus ADV group (n =30) and LdT monotherapy group (n =35).Chi-square test was used to compare ALT normalization rates,rate of HBV DNA load ＜ 500 copies/mL,HBeAg seroconversion and HBsAg seroconversion rates among three groups.Results After 48 weeks of treatment,the ALT normalization rate in IFNα monotherapy group was 52.6％ (10/19),which was lower than those in IFNα plus ADV group (86.7％,26/30) and LdT monotherapy group (84.8％,28/33) (x2 =6.913 and 6.361,P ＜ 0.05).The rate of HBV DNA load ＜500 copies/mL in IFNα monotherapy group was 26.3％ (5/19),which was lower than those in IFNα plus ADV group (60.0％,18/30) and LdT monotherapy group (54.5％,18/33) (x2 =11.33 and 3.895,P ＜0.05).No HBeAg negative conversion or seroconversion was observed in IFNα monotherapy group,but it was observed in 6 (20.0％,6/30) patients in IFNαt plus ADV group and 7 (21.2％,7/33) patients in LdT monotherapy group (x2 =4.330 and 4.657,P ＜ 0.05).No HBsAg seroconversion was observed in three groups.There were no statistical significant differences in ALT normalization rates,rate of HBV DNA load ＜ 500 copies/mL,HBeAg seroconversion and HBsAg seroconversion rates between IFNαt plus ADV group and LdT monotherapy (x2 =0.042,0019 and 0.064,P ＞ 0.05).Conclusion For patients with HBeAg positive CHB who had poor response to IFNα treatment,IFNα plus ADV therapy and LdT monotherapy have the same efficacy in improvement of both liver function and virological response.
