恩替卡韦
乙型肝炎表面抗原
HBeAg
医学
免疫系统
免疫学
内科学
干扰素
抗原
病毒载量
乙型肝炎
聚乙二醇干扰素
胃肠病学
乙型肝炎病毒
慢性肝炎
病毒
利巴韦林
拉米夫定
作者
Robert P. Perrillo,Hsing‐Hua S. Lin,Kathleen B. Schwarz,Philip Rosenthal,Mauricio Lisker‐Melman,Raymond T. Chung,Ludmila Prokunina–Olsson,Gavin Coherty,Jordan J. Feld,NULL AUTHOR_ID
出处
期刊:Hepatology
[Wiley]
日期:2022-03-14
卷期号:76 (3): 775-787
被引量:8
摘要
Treatment of immune-tolerant (IT) children and adults with combined peginterferon alfa-2a and entecavir results in a decline in serum HBeAg and HBsAg concentrations but rarely results in loss of HBeAg or sustained off-treatment response. Factors associated with declines in these viral antigens during treatment remain unexplored.We investigated the pattern of virologic and biochemical response in 86 participants (59 children, 27 adults) by serial quantitative measurement of HBsAg (qHBsAg), quantitative HBeAg (qHBeAg), HBV RNA, interferon-inducible protein (IP-10), IL-18, and alanine aminotransferase (ALT). Each individual had previously been treated with 8 weeks of entecavir followed by 40 weeks of combined peginteferon and entecavir. We defined the interrelationships between these parameters and virologic response measured as nadir declines from baseline for HBeAg and HBsAg. The patterns of HBsAg and HBeAg decline were similar in pediatric and adult participants. Higher levels of IP-10 were observed during treatment in participants with greater ALT elevations and greater reductions of qHBsAg and qHBeAg. Individuals with peak ALT values exceeding three times the upper limit of normal were significantly more likely to have >1 log10 decline in both viral antigens. HBV DNA became undetectable in 21 of 86 (24%) and HBV RNA in 4 of 77 (5%) during therapy, but both markers remained negative only in those who became HBsAg negative, all of whom also had ALT elevations.Induction of IP-10 during peginterferon treatment in adults and children in the IT phase of chronic HBV infection is associated with ALT elevations and decline in viral antigens, suggesting a degree of interferon-inducible viral control.
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