Safety and predictive factors of efficacy of polyethylene glycol interferon in the treatment of chronic hepatitis B with low HBeAg level
Objective To analyze the safety of Polyethylene glycol interferon α-2b(PEG-IFNα-2b)in the treatment of chronic hepatitis B(CHB)with low hepatitis B e antigen(HBeAg)level,and to explore the related factors to predict the efficacy.Methods The clinical data of 188 CHB patients with HBeAg positive and quantitative＜50 S/CO who received PEG-IFNα-2b treatment for the first time in Yantai Qishan Hospital from June 2020 to June 2023 were retrospectively analyzed.Among them,there were 137 males and 51 females,aged(35.04±7.13)years,and the weekly dose of PEG-IFNα-2b was(122.45±27.59)μg.The patients receiving nucleoside(acid)analogues(NAs)were given PEG-IFNα-2b once a week in addition to the original treatment;the patients receiving antiviral therapy for the first time were injected with PEG-IFNα-2b only once a week.If HBeAg turned negative before 48 weeks of treatment,the treatment was consolidated for 12 weeks,otherwise,the treatment was extended to 72 to 96 weeks.According to the efficacy of interferon,they were divided into a HBeAg negative group and a HBeAg non-negative group.The incidence of adverse reactions during the treatment was counted,and the baseline characteristics,biochemical indicators,and virological markers were analyzed.t test,x2 test,and rank sum test were used.Multivariate logistic regression analysis was used to analyze the early factors affecting the efficacy of PEG-IFNα-2b,and the receiver operating characteristic curve(ROC)was used to evaluate the predictive efficacy of related influencing factors on the efficacy.Results Among the 188 patients,41 cases(21.81％),58 cases(30.85％),74 cases(39.36％),and 89 cases(47.34％)achieved HBeAg negative conversion after 12,24,48,and 96 weeks of treatment.During the treatment,151 patients(80.32％)had adverse reactions.After intervention,119 cases(78.81％)were improved.There were statistically significant differences in administration regimen,hepatitis B surface antigen(HBsAg),HBeAg,hepatitis B virus deoxyribonucleic acid(HBV DNA),HBV pregenomic RNA(pgRNA),hepatitis B core-related antigen(HBcrAg),treatment time,and treatment compliance between the two groups(all P＜0.05).Multivariate logistic regression analysis showed that administration regimen(OR=0.536,95％CI=0.348-0.826),treatment compliance(OR=0.461,95％CI=0.256-0.831),treatment time(OR=0.546,95％CI=0.315-0.948),HBeAg(OR=1.876,95％CI=1.537-2.289),pgRNA(OR=2.070,95％CI=1.256-3.412),and HBcrAg(OR=1.602,95％CI=1.134-2.263)were all early influencing factors for the efficacy of PEG-IFN in the treatment of CHB with low HBeAg level(all P＜0.05).ROC analysis showed that the above related factors had certain predictive value for the efficacy of PEG-IFNα-2b in the treatment of CHB with low HBeAg level.Conclusion Administration regimen,treatment compliance,treatment time,HBeAg,pgRNA,and HBcrAg are all early associated factors for the efficacy of PEG-IFNα-2b in the treatment of CHB with low HBeAg level,and have certain value in predicting the efficacy.
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