Objective To investigate the predictive value of systemic immune-inflammation index(SII)combined with albumin(ALB)in the severity of community-acquired pneumonia(CAP)in elderly patients.Methods A retrospective analysis was conducted on 184 elderly patients with CAP in the Respiratory and E-mergency Medicine departments of the hospital from January 2023 to May 2024.According to the 2016 Chi-nese Adult CAP Diagnosis and Treatment Guidelines,patients were divided into severe CAP group(n=76)and non-severe CAP group(n=108).Basic information of patients was collected,routine blood tests and blood biochemical parameters were collected within 24 hours after admission,and the differences in SII,SIRI,hyper-sensitive CRP,and ALB were compared between the two groups.The ROC curve was applied to calculate the area under the curve and analyze the value of SII,SIRI,hypersensitive CRP,and ALB in predicting severe CAP.Results In terms of inflammation indicators,SII,SIRI,hs-CRP,and neutrophil count in the severe CAP group were higher than those in the non-severe CAP group(P<0.05),while lymphocyte count was lower than that in the non-severe CAP group(P<0.05).In terms of blood biochemistry,serum creatinine and BUN in the severe CAP group were higher than those in the non-severe CAP group,while ALB was lower than that in the non-severe CAP group(P<0.05).Binary logistic regression analysis showed that SII and ALB were in-dependent influencing factors for the severity of CAP in elderly patients(P<0.05).The ROC curve showed that the AUC of SII and ALB for predicting severe CAP in the elderly was 0.863 and 0.906,respectively,and the combined AUC was 0.937(0.904,0.970),with a sensitivity of 0.842 and a specificity of 0.880.Conclusion SII combined with ALB can serve as a predictor for early disease severity in elderly patients with CAP.

Objective: Hepatitis B surface antigen (HBsAg) loss is seldom achieved with nucleos(t)ide analog (NA) therapy in chronic hepatitis B patients but may be enhanced by switching to finite pegylated-interferon (Peg-IFN) alfa-2a. We assessed HBsAg loss with 48- and 96-week Peg-IFN alfa-2a in chronic hepatitis B patients with partial response to a previous NA. Methods: Hepatitis B e antigen (HBeAg)-positive patients who achieved HBeAg loss and hepatitis B virus DNA < 200 IU/mL with previous adefovir, lamivudine or entecavir treatment were randomized 1:1 to receive Peg-IFN alfa-2a for 48 (n = 153) or 96 weeks (n = 150). The primary endpoint of this study was HBsAg loss at end of treatment. The ClinicalTrials.gov identifier is NCT01464281. Results: At the end of 48 and 96 weeks' treatment, 14.4% (22/153) and 20.7% (31/150) of patients, respectively, who switched from NA to Peg-IFN alfa-2a cleared HBsAg. Rates were similar irrespective of prior NA or baseline HBeAg seroconversion. Among those who cleared HBsAg by the end of 48 and 96 weeks' treatment, 77.8% (14/18) and 71.4% (20/28), respectively, sustained HBsAg loss for a further 48 weeks. Baseline HBsAg < 1 500 IU/mL and week 24 HBsAg < 200 IU/mL were associated with the highest rates of HBsAg loss at the end of both 48- and 96-week treatment (51.4% and 58.7%, respectively). Importantly, extending treatment from 48 to 96 weeks enabled 48.3% (14/29) more patients to achieve HBsAg loss. Conclusion Patients on long-term NA who are unlikely to meet therapeutic goals can achieve high rates of HBsAg loss by switching to Peg-IFN alfa-2a. HBsAg loss rates may be improved for some patients by extending treatment from 48 to 96 weeks, although the differences in our study cohort were not statistically significant. Baseline and on-treatment HBsAg may predict HBsAg loss with Peg-IFN alfa-2a.