摘要
Abstract
Obiective To analyze the efficacy and the predictive factors of peginterferon α-2a (PEG-IFNα-2a) and adefovir dipivoxil (ADV) combination therapy in patients with HBeAg-positive chronic hepatitis B (CHB). Methods 196 CHB patients positive for HBeAg were divided into PEG-IFNα-2a monotherapy group (n=64),ADV monotherapy group (n=66),and PEG-IFNα-2a plus ADV combination therapy group (n=66). All patients were treated for 48 weeks. Serum INF-γ and IL-10 levels were detected by ELISA. Results At the end of 48 weeks,the serum HBV DNA loss,HBeAg negative,HBeAg seroconversion and ALT normalization rates in PEG-IFNα-2a plus ADV group (74.2%,24.2%,48.5% and 80.3%) were significantly higher than in ADV group (62.1%,13.6%,9.1% and 65.2%,P<0.05) and in PEG-IFNα-2a group (53.1%,10.9%,29.7% and 54.7%,P<0.05);Serum INF-γ levels in combined treatment group [(45.3 ±11.3) pg/ml] were significantly higher than in ADV group [(36.3±11.5) pg/ml,P<0.05] and in PEG-IFNα-2a group [(37.1±10.3) pg/ml,P<0.05];Serum IL-10 levels in combined treatment group [(10.3±14.6) pg/ml] were significantly lower than in ADV group [(18.3±10.5) pg/ml,P<0.05] and in PEG-IFNα-2a group [(17.1±11.3) pg/ml,P<0.05];Serum HBeAg seroconversion rate in com-bined treatment group at the end of 48 weeks was associated with the negative rate of HBeAg at 24 weeks ,e.g. greater than 89.1% reduction of serum HBeAg levels at 24 weeks than baseline had a positive predictive value of 88.7%,negative predictive value of 81.9%,sensitivity of 83.1% and specificity of 87.9%. Conclusion The effica-cy of pegylated interferon α-2a combination with adefovir dipivoxil therapy is superior to monotherapy of either of them in HBeAg-positive chronic hepatitis B patients and the reduction of HBeAg levels at 24 weeks could predict the efficacy of 48 weeks.关键词
慢性乙型肝炎/阿德福韦酯/聚乙二醇干扰素α-2a/疗效预测Key words
Chronic hepatitis B/Adefovir dipivoxil/Peginterferonα-2a/Efficacy/Prediction
