慢性乙型肝炎患者干扰素治疗过程中出现HBeAg/抗-HBe双阳性现象的临床分析  

Clinical characteristics of chronic hepatitis B with concurrent hepatitis B e antigen and antibody detection during the treatment with interferon alpha

作　　者：张健[1] 张艳茹[1] 李威[1] 王俊洁[1] 张浩[1] 陈金军[1] 周元平[1] 

机构地区：[1]南方医科大学南方医院感染内科,广东广州510515

出　　处：《热带医学杂志》2013年第4期446-448,474,共4页Journal of Tropical Medicine

基　　金：广东省自然科学基金(10451051501005787);南方医院新业务新技术项目(201111)

摘　　要：目的探讨慢性乙型肝炎(CHB)患者在干扰素治疗过程中出现E抗原(HBeAg)/E抗体(抗-HBe)双阳性现象的临床意义。方法回顾性分析317例CHB患者,观察聚乙二醇化干扰素(PEG-IFN-α)或普通干扰素(IFN-α)治疗过程中HBeAg/抗-HBe双阳性的发生率、持续时间和临床转归。结果 HBeAg阳性CHB患者在干扰素治疗过程中,HBeAg/抗-HBe双阳性发生率为25.2%。HBeAg/抗-HBe双阳性时HBeAg滴度中位数(范围)为3.45(1.03～187.54)S/CO,抗-HBe滴度为0.52(0.03～0.99)S/CO,均接近于各自截断值。出现过HBeAg/抗-HBe双阳性患者的HBV DNA阴转率、HBeAg阴转率及HBeAg血清转换率分别为76.2%、62.5%、61.2%,高于未出现者的49.8%、35.9%、29.1%,差异均有统计学意义(P均<0.05)。二分类Logistic回归显示,HBeAg阳性患者中,男性更易出现HBeAg/抗-HBe双阳性(OR=1.887;95%CI:1.013～3.518)。结论干扰素治疗过程中,CHB患者出现HBeAg/抗-HBe双阳性的现象并不罕见;其最终临床转归显示更易获得HBeAg血清学转换。Objective To assess clinical characteristics of chronic hepatitis B （CHB） with concurrent hepatitis B e antigen （HBeAg） and antibody （anti-HBe） detection during the treatment with pegylated interferon alpha （PEG-IFN-ot） or interferon alpha （IFN-oL）. Methods A total of 317 CHB patients with HBeAg-positive were enrolled into this retrospective cohort study. Incidence rates, duration, consequences and clinical characteristics of patients with co-existence of HBeAg and anti-HBe were detected and analyzed. Results Of the 317 CHB patients, there were 80（25.2%） with concurrent positive for HBeAg and anti-HBe. The titers of HBeAg and anti-HBe （median and range,S/CO） in the concurrent group were 3.45 （1.03-187.54） and 0.52 （0.03-0.99）, respectively, which were near their own cut-off values. In the HBeAg-positive patients, higher rates of undetectable HBV DNA, HBeAg loss and HBeAg seroconversion were observed in the patients with co-existence of HBeAg and anti-HBe than those without（P〈0.05）. The binary logistic regression results shown that concurrence of hepatitis B e antigen and antibody was more likely occurred in male, who were HBeAg positive （OR=1.887;95% CI：1.013-3.518）. Conclusions In CHB patients treated with interferon, concurrence of HBeAg and anti-HBe is not uncommon. And these patients seemed easier to get HBeAg seroconversion.

关 键 词：慢性乙型肝炎 干扰素 HBEAG 抗-HBe双阳性 

分 类 号：R512.62[医药卫生—内科学]