影响Peg-IFNα-2b治疗HBeAg阴性慢性乙型肝炎患者早期病毒学应答的因素分析*

doi:10.3969/j.issn.1672-5069.2026.02.004

摘要/Abstract

摘要： 目的探讨影响聚乙二醇干扰素α-2b(PEG-IFNα-2b)治疗血清HBeAg阴性的慢性乙型肝炎(CHB)患者早期病毒学应答的因素。方法 2018年1月～2024年1月我院诊治的156例血清HBeAg阴性CHB患者,均接受PEG-IFNα-2b治疗。在治疗12周末,考核早期病毒学应答率。采用ELISA 法检测血清HBsAg,采用PCR法检测血清HBV DNA载量,使用Cytoflex流式细胞仪检测外周血淋巴细胞亚群,应用二元Logistic回归分析早期病毒学应答的影响因素。结果在治疗12周末,本组发生早期病毒学应答62例(39.7);应答组合并脂肪肝百分比、外周血CD8⁺细胞百分比、血清HBsAg水平和HBV DNA载量分别为14.5%、(33.4±4.2)%、(3.6±0.5)lgIU/ mL和(6.0±1.2)lgIU/ mL,均显著低于未应答组[分别为29.8%、(38.6±4.3)%、(8.3±2.7)lgIU/ mL和(7.5±1.4)lgIU/ mL,P<0.05],而血清ALT水平、外周血CD3⁺和CD4⁺细胞百分比分别为(143.3± 5.1)(U/ L、(46.3±5.1)%和(31.1±4.3)%,均显著高于未应答组[分别为(46.1±5.6)(U/ L、(40.0±4.8)%和(25.2±3.7)%,P<0.05];多因素Logistic回归分析结果显示,基线血清HBsAg水平、HBV DNA载量和T淋巴细胞亚群是影响早期病毒学应答的重要因素(P＜0.05)。结论一些机体和病毒因素可能影响Peg-IFNα-2b治疗HBeAg阴性的CHB患者早期病毒学应答,值得深入研究,早做规划,以提高治疗决策的科学性。

关键词: 慢性乙型肝炎, HBeAg阴性, 聚乙二醇干扰素α-2b, 治疗, 早期病毒学应答

Abstract: Objective The aim of this study was to investigate impacting factors on early virological response (EVR) in patients with serum HBeAg-negative chronic hepatitis B (CHB) undergoing pegylated interferon α-2b (PEG-IFN-α2b) therapy. Methods This clinical trial enrolled 156 serum HBeAg-negative patients with CHB in our hospital between January 2018 and January 2024, and all received PEG-IFNα-2b therapy. Serum HBV markers were detected by ELISA, serum HBV DNA loads were assayed by PCR, and peripheral blood lymphocyte subsets were determined by FCM. Multivariate Logistic regression analysis was applied to explore factors affecting EVR, which was evaluated at end of 12 week antiviral treatment. Results By end of 12 week treatment, the EVR was obtained in 62 cases(39.7) in our series; concomitant fatty liver percentage, peripheral blood CD8⁺ cell percentage, serum HBsAg level and HBV DNA load in patients with EVR were 14.5%, (33.4±4.2)%, (3.6±0.5)lgIU/ mL and (6.0±1.2)lgIU/ mL, all significantly lower than [29.8%, (38.6±4.3)%, (8.3±2.7)lgIU/ mL and (7.5±1.4)lgIU/ mL, respectively, P<0.05], while serum ALT level, peripheral blood CD3⁺ and CD4⁺ cell percentages were (143.3± 5.1)(U/ L, (46.3±5.1)% and (31.1±4.3)%, all significantly higher than [(46.1±5.6)(U/ L, (40.0±4.8)% and (25.2±3.7)%, respectively, P<0.05] in those without EVR; multivariate Logistic regression analysis showed that baseline serum HBsAg levels, HBV DNA loads and T lymphocyte subsets were the independent factors impacting EVR acquirement in patients with serum HBeAg-negative CHB(P＜0.05). Conclusion Some host and viral factors could impact virological response in patients with CHB undergoing Peg-IFNα-2b antiviral treatment, which needs further investigation and might help clinicians making an appropriate antiviral strategy.

Key words: Hepatitis B, Hepatitis B e antigen, Pegylated interferon α-2b, Therapy, Early virological response

王玲玲, 张召, 徐玉. 影响Peg-IFNα-2b治疗HBeAg阴性慢性乙型肝炎患者早期病毒学应答的因素分析^*[J]. 实用肝脏病杂志, 2026, 29(2): 175-178.

Wang Lingling, Zhang Zhao, Xu Yu. Impacting factors on early virological response in patients with serum HBeAg-negative chronic hepatitis B undergoing pegylated interferon α-2b therapy[J]. Journal of Practical Hepatology, 2026, 29(2): 175-178.

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影响Peg-IFNα-2b治疗HBeAg阴性慢性乙型肝炎患者早期病毒学应答的因素分析^*

Impacting factors on early virological response in patients with serum HBeAg-negative chronic hepatitis B undergoing pegylated interferon α-2b therapy

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