标题：聚乙二醇干扰素α-2a联合ETV治疗HBeAg阴性CHB临床研究

      作者：李爱新，曹振环，汪雯，张宏伟，张彤，吴昊    (首都医科大学附属北京佑安医院感染科，北京 100069)

      卷次： 2017年28卷5期

      【摘要】 目的 探讨聚乙二醇干扰素α-2a (Peg-IFNα2a)联合恩替卡韦(ETV)治疗HBeAg阴性慢性乙型肝炎(CHB) 48周的疗效及安全性。方法 回顾性纳入 2013年 6月至 2015年 6月在首都医科大学附属北京佑安医院接受 Peg-IFNα2a (135 μg/周)联合ETV (0.5 mg/d)治疗的 50例初治HBeAg阴性CHB患者，收集基线和治疗过程中每 12周的临床数据，包括HBV DNA和HBsAg水平等，分析 48周HBV DNA不可检测率、HBsAg清除率及不良反应发生情况。结果 Peg-IFNα2a联合ETV治疗 48周，全部患者HBV DNA低于检测值(<20 IU/mL)；HBsAg清除率及血清学转换率分别为24%和16%。不良反应主要表现为发热、乏力、脱发、食欲下降、皮疹和甲状腺功能减退，给予对症及支持治疗，均可继续原方案。结论 Peg-IFNα2a联合ETV可提高HBeAg阴性CHB的HBsAg清除率，且安全性良好，是值得探索的优化治疗策略之一。
      【关键词】 恩替卡韦；慢性乙型肝炎；联合治疗；HBsAg；聚乙二醇干扰素α-2a；血清学转换
      【中图分类号】 R512.6+2 【文献标识码】 A 【文章编号】 1003—6350（2017）05—0712—03

Efficacy and safety of peginterferon alfa-2a combined with entecavir in treatment of HBeAg-negative chronichepatitis B.
LI Ai-xin, CAO Zhen-huan, WANG Wen, ZHANG Hong-wei, ZHANG Tong, WU Hao. Department ofInfectious Disease, Beijing You'an Hospital, Capital Medical University, Beijing 100069, CHINA
【Abstract】 Objective To investigate the efficacy and safety of peginterferon alfa-2a (Peg-IFNα2a) combinedwith entecavir (ETV) in treatment of patients with hepatitis B surface antigen (HBeAg)-negative chronic hepatitis B(CHB) for 48weeks. Methods A total of 50 consecutive patients with HBeAg-negative CHB who received Peg-IFNα2a (135 μg/weeks) combined with ETV in Beijing You'an Hospital, Capital Medical University from June 2013 to June2015 were enrolled. Clinical data (including HBV DNA and HBsAg levels) were collected at 12-week intervalsthroughout the treatment course. HBV DNA undetectable rate, HBsAg clearance rate and adverse reactions were ana-lyzed. Results For all patients, the 48-week treatment of Peg-IFNα2a combined with ETV reduced the level of HBVDNA below the detection threshold (<20 IU/mL). The rates of HBsAg clearance and seroconversion were 24% and 16%,respectively. Adverse reactions mainly manifested as fever, fatigue, hair loss, loss of appetite, skin rash and hypothyroid-ism, which were relieved after symptomatic and supportive treatment. Conclusion Peg-IFNα2a combined with ETVcan improve the HBsAg clearance rate of HBeAg-negative CHB, and has a good safety, which appears to be a promisingtreatment strategy.
      【Key words】 Entecavir (ETV); Chronic hepatitis B (CHB); Combination therapy; Hepatitis B surface antigen(HBsAg); Peginterferon alfa-2a (Peg-IFNα2a); Seroconversion·论 著·doi:10.3969/j.issn.1003-6350.2017.05.008