IFNα-2b Antiviral Therapy in 323 Patients with HBeAg-positive Chronic Hepatitis B
Objective To investigate the efficacy of IFNα-2b antiviral therapy in patients with hepatitis B e antigen(HBeAg)-positive chronic hepatitis B(CHB).Methods The clinical data of 323 HBeAg-positive CHB patients who attended the Second Affiliated Hospital of Nanchang Uni-versity and received IFNα-2b from January 2010 to January 2014 were retrospectively analyzed,and they were divided into 3 groups according to alanine aminotransferase(ALT)levels:ALT＜2×ULN(group A1,n=111),2×ULN≤ALT≤ 5×ULN(group A2,n=111),and ALT＞5× ULN(A3 group,n=101).The clinical efficacy and adverse reactions between the 3 groups were observed and the antiviral effects were compared.Results At the time of discontinuation and at weeks 12,24,48,72,96,144,192,and 240 weeks after discontinuation,the HBV-DNA negative conversion rates of the 323 patients were 39.9％,40.2％,39.0％,36.2％,34.1％,33.4％,31.3％,30.7％,and 30.7％,respectively;the HBsAg negative conversion rates were 6.2％,6.2％6.2％,5.9％,5.9％,5.9％,5.6％,5.6％,5.6％,respectively;the HBeAg serological conversion rates were 28.2％,31.0％,32.8％,34.4％,33.7％,33.1％,32.8％,32.5％,31.6％,respectively.At each follow-up time point,the HBV-DNA negative conversion rate and HBeAg seroconversion rate were sig-nificantly higher in group A3 than those in group A2,and they were significantly higher in group A2 than those in group A1(P＜0.05);the difference in the HBsAg negative conversion rate of the three groups of patients was not statistically significant(P＞0.05).All 323 patients had fever and influenza-like symptoms;238(73.7％)had decreased leukocytes and neutrophils;35 patients(10.8％)had abnormal thyroid function;5 patients(1.5％)had baldness;1 patient(0.3％)had sleep disorders.After close observation and symptomatic treatment,the patients successfully com-pleted the course of treatment,and all the indexes were basically normal.Conclusion IFNα-2b an-tiviral therapy for HBeAg-positive CHB patients can yield positive clinical outcomes at the time of discontinuation and during the post-discontinuation follow-up period,and the majority of patients can tolerate adverse effects of IFNα-2b.The antiviral efficacy of IFNα-2b may be related to the ALT level.
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