关键词: 慢性乙型肝炎, 丙酚替诺福韦, 聚乙二醇干扰素α-2b, Toll样受体4, 白细胞介素-35, 治疗

Abstract: Objective The aim of this study was to investigate antiviral efficacy of tenofovir alafenamide (TAF) and peginterferon interferon α-2b (PEG-IFNα-2b) combination in treatment of patients with chronic hepatitis B (CHB). Methods A total of 122 patients with CHB were enrolled in our hospital between March 2021 and March 2023, and were randomly divided into control (n=61) and observation (n=61) group, receiving TAF or TAF and PEG-IFNα-2b combination for antiviral therapy for 48 weeks. Serum HBV DNA loads were detected by real-time fluorescence quantitative PCR, serum HBeAg and HBsAg levels were assayed by electrochemiluminescence, and serum Toll-like receptor 4 (TLR4) and interleukin-35 (IL-35) levels were determined by ELISA. Results By end of 24-week and 48 week treatment, serum HBeAg levels in the combination group were(195.3±36.4)IU/ml and (180.6±25.9)IU/ml, both significantly lower than [(236.1±42.5)IU/ml and (217.5±33.8)IU/ml, P＜0.05], and serum HBsAg levels were (925.1±226.9)IU/ml and (816.2±175.3)IU/ml, significantly lower than [(1028.4±251.5)IU/ml and (921.7±226.8)IU/ml, P＜0.05] in TAF-treated patients; serum HBeAg negativity rates was 21.3% and 29.5%, both significantly higher than 3.3% and 6.6%(P＜0.05) in TAF group; serum TLR4 levels were (68.6±17.4)pg/mL and (41.4±15.9)pg/mL, both much lower than [(90.1±20.5)pg/mL and (73.5±18.2)pg/mL, respectively, P＜0.05], and serum IL-35 levels were (127.9±25.5)pg/mL and (73.5±18.6)pg/mL, both much lower than [(191.4±30.6)pg/mL and (102.7±26.1)pg/mL, respectively, P＜0.05] in TAF group. Conclusion TAF and PEG-IFNα-2b combination in treatment of patients with CHB is efficacious, with a satisfactory serumHBeAg negativity, which might be related to reduced expressions of TLR4 and IL-35 and needs further investigation.

Key words: Hepatitis B, Tenofovir alafenamide, Peginterferon interferon α-2b, Toll-like receptor 4, Interleukin-35, Therapy