昆明医科大学学报2025，Vol.46Issue(6)：79-88,10.DOI:10.12259/j.issn.2095-610X.S20250610
核苷酸类似物单药与联合干扰素治疗慢性乙肝的疗效
Efficacy of Nucleotide Analog Monotherapy and Combination Therapy with Interferon in Treating Chronic Hepatitis B
摘要
Abstract
Objective To analyze the efficacy of different nucleoside(acid)analogs(NAs)used as monotherapy and in combination with pegylated interferon α-2b(Peg-IFN-α-2b)in the treatment of chronic hepatitis B(CHB).Methods A retrospective analysis was conducted on 229 CHB patients who visited the Hepatology Department of the Third People's Hospital of Kunming from September 2022 to August 2023.Patients were divided into six groups based on their antiviral regimen:entecavir(ETV)group(A,n=47),ETV combined with Peg-IFN-α-2b group(B,n=19),Tenofovir Alafenamide(TMF)group(C,n=64),TMF combined with Peg-IFN-α-2b group(D,n=35),Tenofovir Disoproxil Fumarate(TDF)group(E,n=29),and TDF combined with Peg-IFN-α-2b group(F,n=35).The blood routine,liver function,kidney function,HBV serological markers,and HBV-DNA levels were compared before and after 24 weeks of treatment.Results After 24 weeks of treatment,there were no statistically significant differences in efficacy rates and HBV-DNA positivity rates between the monotherapy with NAs and the combination with Peg-IFN-α-2b(P>0.05).Comparing before and after treatment,the ETV group had the highest effective rate,while TDF combined with Peg-IFN-α-2b group had the lowest effective rate.TDF group had the highest efficiency,while ETV combined with Peg-IFN-α-2b group had the lowest efficiency.Except for ETV+Peg-IFN-α-2b and TDF+Peg-IFN-α-2b groups,the HBV-DNA positivity rates in the other four groups were significantly lower after treatment compared to before(P<0.05).There was a significant difference in HBsAg levels among the different treatment regimens of monotherapy with NAs and combination with Peg-IFN-α-2b(P=0.0483).Additionally,except for the ETV and TDF groups,the serum HBsAg levels in the other four groups were significantly lower after treatment compared to before(P<0.05).There were no significant difference in LSM and GFR before and after treatment(P>0.05).In the monotherapy groups,ALT and GGT levels were significantly lower after treatment compared to before(P<0.05),while in the combination Peg-IFN-α-2b group,WBC,NEUT,and PLT levels were significantly lower after treatment compared to before(P<0.05).Conclusion Combination therapy with Peg-IFN-α-2b can reduce HBsAg levels and may be more effective in controlling the virus;however,it may cause adverse reactions such as bone marrow suppression,increasing risks.Physicians and patients need to weigh the benefits against the risks and develop personalized treatment plans based on individual circumstances.关键词
慢性乙型肝炎/聚乙二醇干扰素α-2b/富马酸替诺福韦二吡酯/艾米替诺福韦/恩替卡韦Key words
Chronic hepatitis B/Pegylated interferon α-2b/Tenofovir disoproxil fumarate/Tenofovir alafenamide/Entecavir分类
医药卫生引用本文复制引用
殷瑞,马国伟,岳雯溪,顾海霞,周莹,陈洁..核苷酸类似物单药与联合干扰素治疗慢性乙肝的疗效[J].昆明医科大学学报,2025,46(6):79-88,10.基金项目
云南省科技厅-昆明理工大学"双一流"科技专项基金(202302AG050003-4) （202302AG050003-4）
中国药学会科学传播专业委员会科普研究重点项目(CMEI2024KPYJ00219) （CMEI2024KPYJ00219）
