Reduction of Hepatitis B Surface Antigen May Be More Significant in PEGylated Interferon-Alpha Therapy Combined with Nucleotide Analogues than Combined with Nucleoside Analogues in Chronic Hepatitis B Patients: A Propensity Score Matching Study.

IF 2.7 4区 医学 Q2 Medicine Canadian Journal of Gastroenterology and Hepatology Pub Date : 2022-12-07 eCollection Date: 2022-01-01 DOI:10.1155/2022/4325352
Yiran Xie, Haoxiang Zhu, Yifei Guo, Zhenxuan Ma, Xun Qi, Feifei Yang, Richeng Mao, Jiming Zhang
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Abstract

Background: Nucleotide analogues (NTs) monotherapy may have a more significant effect on reducing hepatitis B surface antigen (HBsAg) than nucleoside analogues (NSs) due to their immunomodulatory function. However, this superiority remains unknown when combined with PEGylated interferon α (PegIFNα). Therefore, this study aimed to explore whether NTs have more significant antiviral effects than NSs in combination therapy with PegIFNα.

Methods: Chronic hepatitis B (CHB) patients treated with PegIFNα plus nucleos(t)ide analogues (NAs) were retrospectively recruited. Efficacy and the predictors of hepatitis B surface antigen (HBsAg) reduction >1 log10 IU/mL after 48 weeks were analyzed.

Results: A total of 95 patients were included and divided into the PegIFNα + NTs group and the PegIFNα + NSs group. Propensity score matching (PSM) was performed. The PegIFNα + NTs group had a greater reduction of HBsAg (-3.52 vs. -2.33 log10 IU/mL, P=0.032) and a higher proportion of patients with HBsAg reduction >1 log10 IU/mL (100.0% vs. 72.2%, P=0.003) even after PSM. However, HBsAg and hepatitis B e-antigen (HBeAg) loss rates, HBeAg seroconversion rates, degree of HBeAg and hepatitis B virus (HBV) DNA decline, HBV DNA undetectable rates, and alanine aminotransferase (ALT) normalization rates showed no significant differences. Subgroup analyses showed the difference in the reduction of HBsAg was particularly evident in HBeAg-positive and the "add-on" subgroups. PegIFNα plus NTs (OR = 36.667, 95% CI = 3.837-350.384) was an independent predictor for HBsAg reduction >1 log10 IU/mL after 48 weeks.

Conclusion: This study suggests that PegIFNα plus NTs may lead to more HBsAg reduction, especially in HBeAg-positive and "add-on" patients.

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在慢性乙型肝炎患者中,PEG化干扰素-α疗法联合核苷酸类似物比联合核苷酸类似物更能显著降低乙型肝炎表面抗原:倾向得分匹配研究》。
背景:核苷酸类似物(NTs)具有免疫调节功能,因此与核苷酸类似物(NSs)相比,单药治疗在降低乙型肝炎表面抗原(HBsAg)方面可能具有更显著的效果。然而,在与聚乙二醇化干扰素α(PegIFNα)联合使用时,这种优越性仍是未知数。因此,本研究旨在探讨在与 PegIFNα 联合治疗时,NTs 是否比 NSs 具有更显著的抗病毒效果:方法:回顾性招募了接受 PegIFNα 加核苷(t)ide 类似物(NAs)治疗的慢性乙型肝炎(CHB)患者。分析了48周后乙肝表面抗原(HBsAg)下降>1 log10 IU/mL的疗效和预测因素:共纳入 95 例患者,分为 PegIFNα + NTs 组和 PegIFNα + NSs 组。进行倾向评分匹配(PSM)。即使在 PSM 后,PegIFNα + NTs 组的 HBsAg 下降幅度更大(-3.52 对 -2.33 log10 IU/mL,P=0.032),HBsAg 下降 >1 log10 IU/mL 的患者比例更高(100.0% 对 72.2%,P=0.003)。然而,HBsAg和乙型肝炎e抗原(HBeAg)丢失率、HBeAg血清转换率、HBeAg和乙型肝炎病毒(HBV)DNA下降程度、HBV DNA检测不到率和丙氨酸氨基转移酶(ALT)正常化率均无显著差异。亚组分析表明,HBsAg 下降的差异在 HBeAg 阳性亚组和 "附加 "亚组尤为明显。PegIFNα加NTs(OR = 36.667,95% CI = 3.837-350.384)是48周后HBsAg下降>1 log10 IU/mL的独立预测因子:本研究表明,PegIFNα加NTs可使HBsAg下降更多,尤其是在HBeAg阳性和 "附加 "患者中。
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来源期刊
CiteScore
4.80
自引率
0.00%
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0
审稿时长
37 weeks
期刊介绍: Canadian Journal of Gastroenterology and Hepatology is a peer-reviewed, open access journal that publishes original research articles, review articles, and clinical studies in all areas of gastroenterology and liver disease - medicine and surgery. The Canadian Journal of Gastroenterology and Hepatology is sponsored by the Canadian Association of Gastroenterology and the Canadian Association for the Study of the Liver.
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