Digest Dis Sci:如何提高HBsAg清除率、降低晚期肝硬化死亡率...

2019-02-27 佚名 爱肝一生微课堂

HBsAg清除是慢性乙型肝炎(CHB)患者抗病毒治疗的理想终点,然而应用有限疗程的口服抗病毒治疗,很难达到该终点。既往研究表明,应用替诺福韦酯(TDF)和聚乙二醇干扰素α-2a(PEG-IFN)联合治疗48周,与应用TDF或PEG-IFN单药治疗相比,治疗后72周时的HBsAg清除率显着升高。

HBsAg清除是慢性乙型肝炎(CHB)患者抗病毒治疗的理想终点,然而应用有限疗程的口服抗病毒治疗,很难达到该终点。既往研究表明,应用替诺福韦酯(TDF)和聚乙二醇干扰素α-2a(PEG-IFN)联合治疗48周,与应用TDF或PEG-IFN单药治疗相比,治疗后72周时的HBsAg清除率显着升高。

韩国延世大学医学院Ahn等近日完成随访120周的分析证实了早期时间点的结果,即CHB患者应用限定疗程的TDF+PEG-IFN联合治疗,与单药治疗相比,HBsAg清除率显着升高。

该项开放标签的活性药对照研究纳入740例CHB患者,随机分为接受TDF+PEG-IFN联合治疗48周(A组)、TDF+PEG-IFN联合治疗16周,然后TDF单药治疗32周(B组)、TDF单药治疗120周(C组)或PEG-IFN单药治疗48周(D组),在120周时,对不同治疗的效果和安全性进行评估。

结果,120周时,A组、B组、C组和D组的HBsAg清除率分别为10.4%、3.5%、0%和3.5%,A组的HBsAg清除率和HBsAg血清学转换率显着高于C组(P值均<0.001)和D组(P值分别为0.002和<0.001)。

原文链接:Ahn SH, Marcellin P, Ma X, et al. Hepatitis B Surface Antigen Loss with Tenofovir Disoproxil Fumarate Plus Peginterferon Alfa-2a: Week 120 Analysis. Digest Dis Sci. 2018 Aug 22.

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    2022-05-09 ms3000001818719076

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    2020-01-30 zhaojie88
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    2019-02-28 zhenjiu124
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    2019-02-27 guging

    谢谢!最新的信息读起来就是收获大

    0

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HBsAg是传统的慢乙肝诊断指标,定量技术的发展开启了HBsAg研究与应用的新纪元。HBsAg定量在慢乙肝诊疗中的新价值包括以下四个方面:

HBeAg阴性慢乙肝抗病毒治疗及HBsAg清除相关优化治疗策略

HBeAg阴性CHB患者多历经了免疫耐受期、免疫活动期和非活动期,故具有年龄大、病程长、肝纤维化程度重的特点。

J Hepatol:应用NAs实现病毒学完全抑制后HBsAg清除能够进一步降低肝癌的发生风险

在实现了完全病毒学抑制的慢性乙型肝炎(CHB)患者中,对功能性治愈有提示意义的表面抗原的血清学清除是否能够带来额外的临床获益是不清楚的。

Liver Int:乙型肝炎病毒感染和非酒精性脂肪肝(NAFLD)风险:基于人群的队列研究

在中国CHB患者中,代谢因素对NAFLD的存在起着重要作用。然而,病毒复制因子与NAFLD没有关系,除了并发2型糖尿病患者。