HBV抗原定量对干扰素联合阿德福韦酯治疗HBeAg阳性慢乙肝的疗效预测

目的了解HBV抗原定量（HBsAg水平）对聚乙二醇干扰素α-2a序贯联合阿德福韦酯（ADV）治疗HBeAg阳性慢性乙肝患者48周疗效的预测。方法62例HBeAg阳性慢性乙肝患者应用聚乙二醇干扰素α-2a治疗24周时,根据疗效进行分组,若HBVDNA≤100IU／ml,定为A组。继续单药治疗至48周;若HBVDNA〉100IU／ml,定为B组,加用ADV治疗至48周。B组患者联合治疗至48周时,若HBVDNA≤100IU／ml,定为Bl组,若HBVDNA〉100IU／ml,定为B2组。疗效评价指标：HBVDNA显著抑制（HBVDNA≤100IU／m1）。治疗过程中监测患者ALT、TBIL、HBVDNA及HBsAg、HBeAg水平,采用SPSSl6．0进行统计学分析。结果基线水平三组患者平均年龄、性别分布、ALT水平差异均无统计学意义（P〉0．05）。A组与B1、B2组患者基线HBVDNA、HBsAg、HBeAg水平差异有统计学意义（P〈0．05）。BI、B2组比较,12周、24周HBsAg下降水平的差异均有统计学意义（P〈0．05）,而HBeAg下降水平的差异无统计学意义（P〉0．05）。结论聚乙二醇干扰素α-2a治疗24周HBVDNA仍高于lOOIU／ml的慢性乙肝患者,12周、24周HBsAg下降水平可以预测加用ADV治疗至48周的疗效。

The levels of HBsAg can predict the efficacy of peglated interferon-alpha 2a combined with adefovir dipivoxil, in HBeAg-positive chronic hepatitis B patients

Objective To investigate the levels of HBsAg in predicting the efficacy of peglated interferon-alpha 2a combined with adefovir dipivoxil( ADV ), in HBeAg-positive chronic hepatitis B patients.Methods This trial enrolled 62 HBeAg-positive chronic hepatitis B patients with detectable HBsAg for at least 6 months prior to screening, serum HBV DNA levels of at least 100 000 IU/ml. The efficacy assessment: viral suppression below 100 IU/ml. The patients with HBV DNA ≤ 100 IU/ml after 24 weeks therapy were divided into group A, in which monotherapy continued; While the rest were divided into group B, in which ADV was combined until week 48. In group B, at the end-of-treatment, the patients with HBV DNA ≤100 IU/ml were divided into group B1, the rest were divided into group B2. Results There was no significant difference on the beseline characteristics of patients between B1 and B2. There was significant difference on the levels of HBsAg at 12-week and 24-week between B1 and B2; while there was no significant difference on the levels of HBeAg. Conclusions The levels of HBsAg at 12-week and 24-week would be predictors to evaluate the efficacy of combined therapy in HBeAg-positive chronic hepatitis B patients.