Efficacy of peginterferon alfa-2a combined with entecavir in sequential treatment of chronic hepatitis B / 中国基层医药

ABSTRACT

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.