The Efficacy And Safety Of IFNα-2b Optimization Treatment On Patients With Hbeag Positive Chronic Hepatitis B

ObjectiveTo compare the efficacy and safety of Interferonα-2b(IFNα-2b)optimization therapy、IFNα-2b monotherapy and Entecavir(ETV)monotherapy in HBeAg-positive chronic hepatitis B(CHB)patients,and provide more clinical treatment therapies to the HBeAg-positive chronic hepatitis B patients.MethodThe prospective nonrandomized analysis methods were conducted in this study.All CHB patients in this study and his or her family were fully informed the purpose of this study and the ruquirements,as well as the pros and cons of ETV and IFNα-2b and related side effects.The patients were divided into IFNα-2b optimization therapy group(A)、IFNα-2b monotherapy group(B)and ETV monotherapy group(C)according to the selection of patients.In group A(79 patients),the patients were tested for the virological response when received IFNα-2b monotherapy for 24weeks,group A1(35 patients)whose HBV DNA<10~3IU/mL continue to use IFNα-2b monotherapy for 48 weeks,group A2(44 patients)with HBV DNA≥10~3IU/mL accept ETV add-on therapy for 48 weeks,Group B(53 patients)accept IFNα-2b monotherapy for 48 weeks.Group C(67 patients)accept ETV monotherapy for 72weeks.The liver function indexes,virological response,HBeAg clearance rate and serological conversion rate of three groups were evaluated at 48 weeks and 72 weeks respectively.ResultThe various clinical indicators were compared among the three groups at 48weeks:(1)The ALT recovery rate of group A and C were significantly higher than that of group B(Avs.B,p<0.0001;Cvs.B,p<0.0001),and there was no statistical difference between A and C(p=0.1769).(2)The HBV DNA inhibition rate of group A and C were significantly higher than that of group B(Avs.B,p<0.0001;Cvs.B,p=0.0003),and there was no statistical difference between A and C(p=0.5189).(3)The HBeAg clearance rate of groupA was significantly higher than that of groupB and C(Avs.B,p<0.0001;Avs.C,p<0.0001),and there were no statistical difference between groupB and C(p=0.3996).(4)The HBeAg conversion rate of groupA was higher than that of groupB and C(Avs.B,p=0.0023;Avs.C,p<0.0001),and there was no statistical difference between groupB and C(p=0.3609).(5)There were no statistical difference in HBsAg clearance rate among the three groups(Avs.B,p=0.7677;Avs.C,p=0.9341;Bvs.C,p=0.9061).At 72 weeks,there were no statistical difference in ALT recovery rate、HBV DNA inhibition rate and HBsAg clearance rate between groupA and groupC(p=0.0996,p=0.7655,p=0.1742),the HBeAg clearance rate and conversion rate of groupA were higher than those of groupC(p<0.0001,p<0.0001).There were no statistical difference of the adverse events rate between groupA and B.ConclusionFor HBeAg-positive chronic hepatitis B patients,IFNα-2b optimization therapy is superior to IFNα-2b monotherapy and ETV monotherapy,and has good safety.