医学
HBeAg
内科学
胃肠病学
慢性肝炎
基因型
乙型肝炎病毒
免疫学
聚乙二醇干扰素α-2a
聚乙二醇干扰素
α-干扰素
乙型肝炎
α-干扰素
逻辑回归
乙型肝炎表面抗原
干扰素
病毒
利巴韦林
生物
基因
生物化学
作者
Erik H.C.J. Buster,Bettina E. Hansen,George Lau,Teerha Piratvisuth,Stefan Zeuzem,Ewout W. Steyerberg,Harry L.A. Janssen
标识
DOI:10.1053/j.gastro.2009.08.061
摘要
Therapy with pegylated interferon (PEG-IFN)-alfa results in sustained response in a minority of patients with chronic hepatitis B virus (HBV) infection and has considerable side effects. We analyzed data from the 2 largest global trials of hepatitis B e antigen (HBeAg)-positive patients with chronic hepatitis B to determine which are most likely to respond to PEG-IFN-alfa therapy.The study included 542 patients treated with PEG-IFN-alfa-2a (180 microg/wk, 48 wk) and 266 patients treated with PEG-IFN-alfa-2b (100 microg/wk, 52 wk). Eighty-seven patients were excluded, leaving 721 patients for analysis. A sustained response was defined as HBeAg loss and HBV-DNA level less than 2.0 x 10(3) IU/mL 6 months after treatment. Logistic regression analysis was used to identify predictors of sustained response and a multivariable model was constructed.HBV genotype, high levels of alanine aminotransferase (ALT; >or=2 x upper limit of normal), low levels of HBV DNA (<2.0 x 10(8) IU/mL), female sex, older age, and absence of previous IFN therapy predicted a sustained response. Genotype A patients with high ALT and/or low HBV-DNA levels had a high predicted probability (>30%) of a sustained response. The strongest predictors of response were a high level of ALT in genotype B patients and a low level of HBV DNA in genotype C patients. Genotype D patients had a low chance of sustained response, irrespective of ALT or HBV-DNA levels.The best candidates for a sustained response to PEG-IFN-alfa are genotype A patients with high levels of ALT or low levels of HBV DNA, and genotypes B and C patients who have both high levels of ALT and low HBV DNA. Genotype D patients have a low chance of sustained response.
科研通智能强力驱动
Strongly Powered by AbleSci AI