Efficacy Of Pegylated Interferon ? In The Treatment Of HBeAg-positive CHB With Normal Or Mild Elevated ALT And METAVIR Scores?G2S2

Background Serum HBVDNA levels,alanine aminotransferase(ALT)levels,liver histopathic inflammation and fibrosis are also considered in three aspects of antiviral therapy in patients with CHB.In addition,the age,health status and resistance Availability of viral drugs.For patients with persistent HBV DNA positive,ALT normal or mild elevated CHB,such as liver histopathology showed Knodell HAL ? 4,or inflammatory necrosis ? G2,or fibrosis ? S2,should be actively given antiviral therapy.At present,there is a lack of research on the treatment of Peg IFN-? in the treatment of ALT normal or mild,but METAVIR score ? G2S2 HBe Ag-positive chronic hepatitis B,this study is a retrospective study aimed at ALT normal or mild elevated METAVIR Score ?G2S2 HBe Ag positive chronic hepatitis B patients with individualized antiviral therapy provide reference information.Objective To investigate the efficacy of pegylated interferon-?(Peg IFN-?)in the treatment of ALT or HBs Ag,HBe Ag,HBV DNA in patients with normal or mild elevated METAVIR score ? G2S2 HBe Ag-positive chronic hepatitis B,(HBs Ag,HBe Ag,HBV DNA,Fibroscan elasticity,liver histopathology(METAVIR score)and other indicators and 48 weeks of treatment at the end of the virological response and HBe Ag serology And to predict the value of ALT for normal or slightly elevated METAVIR score ? G2S2 HBe Ag positive chronic hepatitis B patients with individualized antiviral therapy to provide reference information.Methods From May 2011 to January 2016,the normal course of ALT was normal or slightly elevated in the Department of Hepatology,the Second Hospital of Lanzhou University,and the patients with chronic hepatitis B were treated with Peg IFN-? and the course of treatment was ? 48 weeks of patients in 36 cases.The levels of ALT,HBs Ag,HBe Ag,HBV DNA and Fibroscan elasticity were measured at the end of 48 weeks of treatment with Peg IFN-?,and the histopathological changes of patients were analyzed.The sex,age,baseline ALT,HBs Ag,HBe Ag,HBV DNA,Fibroscan elasticity,liver histopathology(METAVIR score)and the relationship between virological response and HBe Ag seroconversion at the end of 48 weeks and its predictive value.Results 1.Peg IFN-? treatment of ALT normal or mild elevated METAVIR score ? G2S2 HBe Ag positive chronic hepatitis B patients,36 patients 24 weeks,48 weeks when the virological response rates were 41.7%,50.0%,24 weeks,The seroconversion rate of HBe Ag was 25.0% and 38.9% at 48 weeks,19.4% of the HBe Ag seroconversion at the same time at 24 weeks,and the virological response and HBe Ag seroconversion ratio were 30.6%.2.In this study,Peg IFN-? antiviral treatment 48 weeks of virological response and HBe Ag serological conversion into grouping basis,and further baseline and treatment of the clinical indicators were compared,the results showed:(1)ALT,HBs Ag,HBe Ag,HBV DNA,Fibroscan elasticity of the average level from the treatment to the end of 48 weeks after treatment showed a general decline in the treatment of 12 weeks of mild a slight increase in ALT,Fibroscan elasticity before treatment 12 weeks No significant decline in treatment after 12 weeks gradually decreased slowly.(2)In this study,single factor ?2 analysis was performed on the baseline indexes(gender,age,ALT,HBs Ag,HBe Ag,HBV DNA,Fibroscan elasticity,G,S),which might affect the virological response and HBe Ag serological conversion.The serological response rate of HBe Ag was higher and the HBe Ag seroconversion rate was higher in patients with low baseline HBe Ag,and further secondary logistic regression analysis showed that baseline HBV DNA <100000 IU / ml patients with virological response rate and HBe Ag seroconversion rate was significantly higher than the baseline HBV DNA ? 100000 IU / ml patients.Baseline HBV DNA <100000 IU / ml had a good predictive value for virological response and HBe Ag serological conversion.The HBe Ag seroconversion rate was significantly higher in patients with baseline HBe Ag <300 COI than in patients with baseline HBe Ag?300 COI.Baseline HBe Ag <300 COI has a good predictive value for HBe Ag serological conversion.Conclusion 1.ALT levels of normal or slightly elevated HBe Ag-positive patients with chronic hepatitis B,there will be significant liver inflammation or fibrosis changes.Such patients even if ALT is normal or only mildly elevated,if liver histology suggests inflammation and fibrosis progression(METAVIR score ? G2S2),the use of Peg IFN-? antiviral therapy can make a considerable number of patients to achieve HBe Ag serological conversion and viral replication Inhibit,prevent the progress of liver inflammation and fibrosis.But at the same time,some patients after 48 weeks Peg IFN-? antiviral therapy did not achieve HBe Ag serological conversion or viral replication inhibition.Antiviral therapy for HBe Ag-positive chronic hepatitis B is a long-term process requiring both HBe Ag seroconversion and viral replication inhibition.2.It is necessary to regularly monitor the serum levels of ALT,HBs Ag,HBV DNA,HBe Ag and Fibroscan in patients with HBe Ag-positive chronic hepatitis B who use Peg IFN-? antiviral therapy.We observed the baseline and dynamic changes Can effectively understand the process of change,help to further adjust the medication according to changes in condition.Before treatment,according to the baseline-related indicators to evaluate the efficacy of the use of individual antiviral treatment program has a good reference value.