Sequential Interferon Alpha-2b Therapy in 46 Chronic Hepatitis B Patients with Poor Nucleoside Analog Response
Objective To investigate the efficacy of sequential IFN α-2b therapy in patients with chronic hepatitis B(CHB)treated with nucleoside(acid)analogs(NAs),and to provide clini-cal reference for antiviral therapy in CHB patients with poor response to NAs.Methods Of 46 pa-tients with CHB treated with NAs,31 patients with NAs resistance were established as the N1 group and 15 patients with partial virologic response to NAs were categorized as the N2 group;both groups received sequential IFN α-2b overlapping NAs for 12 to 24 weeks,and then discontin-ued NAs and were given sequential IFN α-2b therapy only.Patients'hepatitis B pentameters[hepatitis B surface antigen(HBsAg),hepatitis B surface antibody(HBsAb),hepatitis B e antigen(HBeAg),hepatitis B e antibody(HBeAb),and hepatitis B core antibody(HBcAb)]and hepatitis B DNA quantification(HBV-DNA)were collected.The relevant indexes at the 12th,24th and 48th weeks(T1,T2 and T3)were compared between the 2 groups.Results One case was shed in Group N1 due to severe insomnia.The HBV-DNA quantifications of patients in Groups N1 and N2 were significantly lower than their baseline values at the T1,T2 and T3 treatment time points(P＜0.05),but the difference in the HBV-DNA quantifications was not statistically significant in the 2 groups(P＞0.05).Virologic response rates in Groups N1 and N2(T1:53.3％and 40.0％;T2:60.0％and 47.0％;T3:50.0％and 53.0％),HBsAg-negative rates(T1:6.6％and 0.0％;T2:10.0％and 0.0％;T3:13.3％and 0.0％),HBeAg-negative rates(T1:17.4％and 0.0％;T2:26.0％and 0.0％;T3:26.0％and 36.4％)and HBeAg serologic conversion rates(T1:0.0％and 0.0％;T2:4.3％and 0.0％;T3:4.3％and 18.2％)were not statistically significant when compared at each time point(P＞0.05).None of them experienced serious adverse effects during treatment,and no adverse events such as liver failure occurred after discontinuation of NAs.Conclusion IFNα-2b sequential therapy can have positive clinical outcomes,achieving discontinuation of NAs and showing favorable safety profile,and it can be considered as one of the optimal antiviral regimens for the management of patients with NAs-resistant and partially virological-responsive CHB.
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