ABSTRACT
Objective To investigate the efficacy of individualized interferon (IFN)-alpha therapy in HBeAg-negative chronic hepatitis B patients. Methods Seventy- six Chinese HBeAg-negative chronic hepatitis B patients proven by liver biopsy were treated with 5 MU recombinant IFN-alpha 1b subcutaneously thrice every week. All the patients were followed up for at least 24 months the combined responses were defined as normalization of serum alanine transaminase (ALT) and HBV DNA＜3 log10 copy/mL. An intention-to-treat (ITT) analysis was used in this paper in which all 76 patients were included. Results Six patients were lost. Treatment duration was in the range 2-24 months with a median of 8.5 months, and combined responses were achieved at a median of 6.0 months (range 2-19 months) of treatment duration.Seventy-five-percentile of treatment duration to endpoints was 10.0 months. The combined response rate was 46.1% (35/76) at the end of treatment, 43.3% (33/76) at 12-month follow-up and 40.8% (31/76) at 24-month follow-up. The relapse rate was 20. 0% (7/35) and 25. 7% (9/35) at 12-month and 24-month follow-up, respectively. Higher necroinflammatory activity in liver biopsy predicted a good response, while gender, age, liver fibrosis, baseline ALT, aspartate aminotransferase levels and baseline HBV DNA levels were not impact factors of therapeutic effects by binary Logistic regression analysis.Conclusion Individualized prolonged IFN-alpha regimen lead to considerable sustained disease suppression in patients with HBeAg-negative chronic hepatitis B.
ABSTRACT
<p><b>OBJECTIVE</b>To discuss the diagnostic value of ultrasonic examination in patients with early liver cirrhosis and the relation with different stages of liver fibrosis.</p><p><b>METHODS</b>In the series, 263 patients with chronic hepatitis B were under taken liver biopsy and ultrasonic examination of type B for determination of liver cirrhosis images, width of the main portal vein and the splenic vein, tumefaction of the spleen. Data were analysed statistically.</p><p><b>RESULTS</b>Sixties of 263 patients were diagnosed as early liver cirrhosis. The diagnostic sensitivity, specificity, misdiagnostic rate, missed diagnostic rate, and Jonden's index of ultrasonic examination for early liver cirrhosis were 52.5%, 88.3%, 11.7%, 47.5%, and 0.508, respectively. The width of the main portal vein with liver fibrosis of S1, S2, S3, and S4 were 10.93 mm +/- 1.25 mm, 11.35 mm +/- 1.06 mm,11.29 mm +/- 1.52 mm, and 11.4 8mm +/- 1.25 mm, respectively with statistic difference between S4 and S1 (P=0.03). The width of the spleen vein of S1, S2, S3, and S4 were 6.518 mm +/- 2.033 mm, 7.190 mm +/- 1.569 mm, 7.444 mm +/- 1.805 mm and 8.406 mm +/- 2.227 mm, respectively with statistic difference between S4 and S2 (P=0.035). The incidence of tumefaction of the spleen was increased with the degree of liver fibrosis.</p><p><b>CONCLUSIONS</b>The diagnostic sensitivity of ultrasonic examination for early liver cirrhosis is low. The width of the main portal vein, the spleen vein and the incidence of tumefaction of the spleen are related with the degree of liver fibrosis. The regeneration node of liver cirrhosis may contribute to the development of portal hypertension.</p>