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Objective:To investigate the efficacy of peginterferon alfa-2a (Peg-IFNα-2a) combined with entecavir in sequential treatment of chronic hepatitis B.Methods:A total of 106 patients with chronic hepatitis B who received treatment in Affiliated Hangzhou Xixi Hospital of Zhejiang University School of Medicine from January 2020 to February 2022 were included in this study. They were divided into a control group (entecavir treatment, n = 53) and a study group (sequential therapy with Peg-IFNα-2a followed by entecavir, n = 53). Liver function indicators, liver fibrosis indicators, clinical treatment efficacy, and incidence of adverse reactions were compared between the two groups before and after treatment. Results:After treatment, total bilirubin, alanine aminotransferase and aspartate transaminase in the control and study groups were (94.79 ± 8.71) μmol/L and (67.67 ± 9.19) μmol/L, (256.93 ± 44.07) U/L and (186.56 ± 48.37) U/L, (256.47 ± 43.73) U/L and (200.69 ± 41.34) U/L, and they were (140.05 ± 26.15) μmol/L and (141.32 ± 25.35) μmol/L, (433.66 ± 77.16) U/L and (429.77 ± 73.73) U/L, (352.34 ± 65.19) U/L and (354.05 ± 66.13) U/L before the treatment. After treatment, these indexes in each group were decreased compared with before treatment ( t = 19.19, -12.13, -28.85, -20.96, -19.27, -12.03, all P < 0.05). After treatment, these indexes in the study group were significantly lower than those in the control group ( t = -6.49, -7.30, -6.74, all P < 0.001). After treatment, the levels of hyaluronic acid, laminin, type III procollagen peptide, and type IV collagen in the control and study groups were (124.91 ± 22.99) μg/L and (101.29 ± 22.67) μg/L, (132.71 ± 25.37) μg/L and (110.56 ± 25.49) μg/L, (116.93 ± 20.29) μg/L and (93.14 ± 20.39) μg/L, (63.14 ± 12.19) μg/L and (50.81 ± 11.63) μg/L, and they were (175.73 ± 48.56) μg/L and (177.61 ± 48.51) μg/L, (163.43 ± 41.52) μg/L and (165.57 ± 41.59) μg/L, (139.71 ± 31.75) μg/L and (141.72 ± 31.78) μg/L, (106.97 ± 32.24) μg/L and (104.02 ± 34.12) μg/L before treatment. After treatment, the levels of these indexes in each group were significantly decreased compared with before treatment ( t = -13.04, -8.68, -10.43, -5.82, -13.35, -6.26, -13.02, -10.72, all P < 0.05). After treatment, the levels of these indexes in the study group were significantly lower than those in the control group ( t = -5.32, -4.48, -6.02, -5.32, all P < 0.001). The total response rate in the study group was 88.68% (47/53), which was significantly higher than 62.26% (33/53) in the control group ( χ2 = 9.98, P < 0.05). The HBsAg conversion rate in the study group was 33.96% (18/53), which was significantly higher than 1.32% (6/53) in the control group ( χ2 = 7.75, P < 0.05). There was no statistically significant difference in the incidence of adverse reactions between the study and control groups [26.42% (14/53) vs. 30.19% (16/53), χ2 = 0.81, P > 0.05]. Conclusion:Sequential therapy with Peg-IFNα-2a followed by entecavir can effectively improve liver function,reduce liver fibrosis , improve clinical treatment efficacy, and will not increase adverse reactions.
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Objective To observe the therapeutic efficacy of extended therapy with interferon and a nucleoside analogue for treating patients with HBeAg?positive chronic hepatitis B( CHB)?Methods Sixty cases patients diagnosed with CHB in You′an Hospital of Beijing Affiliated to Capital Medical University from March 2012 to May 2015 were retrospectively analyzed?They were divided into group A with 29 cases and group B with 31 cases according to different treatment methods?Group A were treated with pegylated interferonα?2a( Peg?IFNα?2a) combined with adefovir dipivoxil for 96 weeks,group B were treated with Peg?IFN α?2a combined with adefovir and lamivudine for 96 weeks?The patients'recovery rate of ALT,hepatitis B virus( HBV) DNA response rate and HBeAg and HBsAg seroconversion rate and conversion rate of 12,24,48,96 weeks in the treatment were observed?Results There were no significant differences in recovery rate of ALT,hepatitis B virus( HBV) DNA response rate,HBeAg seroconversion rate and HBsAg seroconversion rate between the two groups at differenct time points( P>0?05)?HBeAg seroconversion rates in group A were 34?5% at 48 weeks,62?1% at 96 weeks, and the difference was significant( P=0?036)?HBeAg seroconversion rates in group B were 35?5% at 48 weeks, 61?3% at 96 weeks,and the difference was significant ( P=0?042)?Conclusion The treatment of peginterferonα?2a in combination with adefovir dipivoxil and lamivudine is not more efficacious than peginterferon α?2a in combination with adefovir dipivoxil?The extended treatment of Peg? IFNα?2a plus a nucleoside analogue can achieve high rates of HBeAg seroconversion in patients with HBeAg?positive CHB.