摘要
目的 观察和分析重组α干扰素（rIFNα）治疗CHB过程中出现病毒学反弹与干扰素中和抗体（NAb）产生的关系。方法 485例经肝穿刺活组织检查证实的CHB患者,给予rIFNα1b治疗,每次5×106U,每周3次,疗程个体化（6-37个月,中位数10个月）,疗程中1-3个月检测1次肝功能,并以PCR荧光定量测定HBV DNA、Abbott EIA试剂检测HBeAg、抗病毒生物中和法检测NAb。结果 485例患者中,66例（13．6％）于治疗过程中出现病毒学反弹,NAb阳性98例（20．2％）,病毒学反弹组NAb阳性率68．2％（45／66）,显著高于未发生病毒学反弹组的12．6％（53／415）,差异有统计学意义（x^2=109．06,P〈0．01）。NAb阳性组病毒学反弹的发生率为45．9％（45／98）,显著高于NAb阴性组的5．4％（21／387）,差异有统计学意义（x^2=109．06, P〈0．01）。病毒学反弹的时间与NAb检出的时间存在相关性及一致性（CR=98．3％,P〈0．01）。多因素分析表明,NAb的检出是病毒学反弹发生的相关因素之一（P〈0．01）,患者的年龄和治疗前HBeAg状态亦可影响病毒学反弹的发生。结论 rIFNα治疗CHB过程中病毒学反弹的发生率约13．6％,病毒学反弹的发生与NAb的产生密切相关,患者的年龄和治疗前HBeAg水平亦可影响病毒学反弹的发生。
Objective To investigate the relationship of virological breakthrough and production of neutralizing anti-interferon antibody （NAb） in chronic hepatitis B patients treated with recombinant interferon-alpha （rIFN-alpha）. Method Four hundred eighty-five patients with histological proven chronic hepatitis B were treated with 5 MU recombinant interferon-alpha lb （rIFN- α lb） thrice weekly for 6-37 months （median 10）. Serum HBV DNA, HBeAg and NAb levels of the patients were detected by fluoresecent-quantitative PCR, enzymoimmunoassay and antiviral neutralizing biological assay respectively during the therapy. Results Virological breakthrough occurred in 66 patients （13.6%）, and NAb was found in 98 patients （20.2%） of the total 485 patients. The rate of NAb positivity was higher in patients with viral breakthrough than those without it （68.2%, 45/66, vs 12.6%, 53/419, x^2 = 109.06, P 〈 0.01）, and viral breakthrough occurred more in patients with positive NAb than with negative NAb （45.9%, 45/98, vs 5.4%, 21/387, x^2 = 109.06, P 〈 0.01）. The time of the viral breakthrough occurrence and the time of NAb production had a significant correlation （P 〈 0.01）. The occurrence of viral breakthrough was also influenced by the age of patients （P 〈 0.05） and HBeAg status （P 〈 0.01） before they were treated. Conclusion Viral breakthrough occurred in 13.6% of our 485 chronic hepatitis B patients treated with recombinant interferon-alpha. Their viral breakthrough and production of NAb production had a significant correlation.
出处
《中华肝脏病杂志》
CAS
CSCD
北大核心
2007年第6期422-424,共3页
Chinese Journal of Hepatology
关键词
肝炎
乙型
慢性
干扰素I型
重组
抗体
病毒学反弹
Hepatitis B, chronic
Interferon type I, recombinant
Antibodies
Viral rebound
