慢性乙型肝炎患儿更早期接受恩替卡韦单药治疗可能提高HBsAg转阴率  

Entecavir monotherapy in children with chronic hepatitis B in early life of children may improve the HBsAg seroconversion

作　　者：王嘉 郑婕[3] 石磊[1] 王宏利 姚耐娟 朱娅鸽[1] 焦哲 张裕斌 陈天艳[1] WANG Jia;ZHENG Jie;SHI Lei;WANG Hongli;YAO Naijuan;ZHU Yage;JIAO Zhe;ZHANG Yubin;CHEN Tianyan(Department of Infectious Diseases,the First Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710061;The Sixth Department of Liver Diseases,the Eighth Hospital of Xi′an;Department of Medical Imaging,the First Affiliated Hospital of Xi′an Jiaotong University,China)

机构地区：[1]西安交通大学第一附属医院感染科,陕西西安710061 [2]西安市第八医院肝病六科 [3]西安交通大学第一附属医院医学影像科

出　　处：《胃肠病学和肝病学杂志》2024年第12期1665-1668,共4页Chinese Journal of Gastroenterology and Hepatology

基　　金：陕西省重点研发计划(2021ZDLSF04-14)。

摘　　要：目的探索不同年龄段慢性乙型肝炎患儿接受恩替卡韦单药治疗的疗效差异。方法回顾性分析2013年6月至2023年3月在西安交通大学第一附属医院感染科就诊的38例慢性乙型肝炎患儿,至少接受恩替卡韦单药抗病毒治疗24周,观察患儿接受治疗后的肝功、乙肝病毒血清学标志物、乙肝病毒定量的变化及不良反应。结果38例慢性乙型肝炎患儿,接受抗病毒治疗的年龄中位数为6.3岁(2.0~14.6岁),中位随访时间为3.6年(0.6~9.8年),35例(92.1%)患儿ALT复常,29例(76.3%)患儿HBV DNA转阴,16例(45.7%)患儿HBeAg转阴,7例(18.4%)患儿HBsAg转阴。接受恩替卡韦单药治疗后,≤3岁患儿HBeAg转阴率(88.9%vs 30.8%,P=0.0049)及HBsAg转阴率(60.0%vs 3.6%,P=0.0005)显著高于>3岁患儿。结论慢性乙型肝炎儿童更早期(3岁以下)开始接受恩替卡韦单药治疗可能提高HBsAg转阴率。Objective To explore the efficacy of Entecavir monotherapy in children with chronic hepatitis B(CHB)in different ages.Methods A total of 38 CHB children outpatients of the First Affiliated Hospital of Xi′an Jiaotong University from Jun.2013 to Mar.2023 were enrolled into this retrospective study who were received Entecavir monotherapy at least 24 weeks.The changes of liver function,hepatitis B virus serum markers,HBV DNA and adverse reactions of the 38 children were observed.Results The median antiviral age of the 38 children was 6.3 years old(2.0-14.6 years old).The median follow-up time was 3.6 years(0.6-9.8 years).Thirty-five children(92.1%)had ALT normalization.HBV DNA was undetected in 29 children(76.3%),HBeAg was undetected in 16 children(45.7%),and HBsAg was undetected in 7 children(18.4%).The rate of HBeAg loss(88.9%vs 30.8%,P=0.0049)and HBsAg loss(60.0%vs 3.6%,P=0.0005)were significantly higher in children under 3 years old,compared with those in children older than 3 years old.Conclusion The initiation of Entecavir monotherapy before 3 years old in children with chronic hepatitis B may improve the HBsAg seroconversion.

关 键 词：乙型肝炎病毒 儿童 恩替卡韦 慢性乙型肝炎 

分 类 号：R575[医药卫生—消化系统]