Efficacy of nucleos（t）ide analogues combined with peginterferon α-2b on antiviral therapy in children with chronic hepatitis B
10.3760/cma.j.cn112866-20250608-00117
- VernacularTitle:聚乙二醇干扰素α-2b联合核苷（酸）类似物对儿童慢性乙型肝炎抗病毒治疗的影响
- Author:
Wenting CHEN
1
;
Shilian LI
1
;
Xiaochen MA
1
;
Fang CHEN
1
;
Lijian RAN
1
;
Yi WU
1
;
Yan GUO
1
;
Yan ZHU
1
;
Qing MAO
1
;
Huimin LIU
1
Author Information
1. 陆军军医大学（第三军医大学）西南医院感染病科 病毒传染病精准防治重庆市重点实验室，重庆 400038
- Publication Type:Journal Article
- Keywords:
Children;
Chronic hepatitis B;
Nucleos（t）ide analogue;
Peginterferon;
Clinical cure
- From:
Chinese Journal of Experimental and Clinical Virology
2025;39(4):411-418
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the efficacy of combination of peginterferon α-2b（Peg-IFN α-2b）with nucleos（t）ide analogues（NAs）on antiviral therapy in children with chronic hepatitis B（CHB）and to provide an optimized clinical treatment strategies for CHB children.Methods:A retrospective analysis was conducted on 30 CHB children treated in The First Affiliated Hospital of the Army Medical University（Southwest Hospital）from January 2022 to January 2025 with treatment duration at least 48 weeks. The enrolled children were aged between 2 and 17 years and divided into the NAs combined with Peg-IFN α-2b（NPI）group（n=13）and NAs group（n=17）by their therapy regimens. The characteristics of baseline，week 12，week 24，week 48 and week 96 were compared between groups，as well as the differences in response to biochemical，immune and viral indicators at each observation point. Logistic regression analysis and receiver operating characteristic（ROC）curve analysis were performed to identify factors influencing the HBsAg seroclearance. Results:At baseline of treatment，the proportion of HBeAg positivity in the NPI group and the NAs group was high（76.9% vs 86.6%， χ2=0.679， P=0.628），and the alanine aminotransferase（ALT）and aspartate aminotransferase（AST）in the NPI group were significantly lower than those in the NAs group（ P<0.001）. At 24 weeks，the decrease in HBsAg in the NPI group was also significantly higher than that in the NAs group（ Z=-3.161， P=0.002）. Finally，the cumulative seroclearance rate of HBsAg at 96 weeks in the NPI group was significantly higher than that in the NAs group（46.15% vs 5.88%， χ2=0.679， P=0.025）. Mulitivariate Logistic regression analysis showed that treatment regimen and gender were risk factors affecting the outcome of HBsAg（ P<0.05）. ROC curve analysis showed that the increase in ALT at 12 weeks compared with baseline（AUC=0.857，Cutoff value=3.615 IU/L），the decrease in ALT at 24 weeks（AUC=0.870，Cutoff value=47.85 IU/L），and the decrease in HBsAg at 12 weeks and especially at 24 weeks（AUC=0.885，Cutoff value=0.97log IU/ml）were effective predictors of HBsAg prognosis at 96 weeks. Conclusion:In CHB children，antiviral regimen Peg-IFN α-2b combined with NAs was more effective than NAs alone in improving the HBsAg seroclearance rate of CHB，and the effects in female were better than in male. The decline of HBsAg and the fluctuation of ALT in the early treatment period are valid predictors of HBsAg clearance.
