Clinical Efficacy And Safety Analysis Of Interferon α-2b Sequential Nucleoside(acid) Analogues In 62 Patients With Chronic Hepatitis B

ObjectiveThe clinical data of 62 patients with nucleoside(acid)analogues(NAs)treated with sequential IFNα-2b antiviral therapy in patients with chronic hepatitis B(CHB)were analyzed.The efficacy and safety of the patients were analyzed.MethodologyThe clinical data of 62 patients with CHB treated with NAs were collected,including 31 patients with NAs resistance(23 patients with HBeAg positive);15 patients with partial virological response to NAs(11 patients with HBeAg positive)and 16 patients with virological response for NAs(4 patients with HBeAg positive),both sequential IFNα-2b(recombinant human interferon α-2b 5 million IU intramuscular injection,once a day for the first 2 weeks,followed by the next day)overlapping NAs treatment for 3 to 6 months to discontinue NAs alone IFN,IFNα-2b is a basic course of treatment from 48 weeks to 72 weeks.Analysis of virological response rate,HBsAg negative conversion rate,HBeAg negative conversion rate,HBeAg seroconversion rate,biochemical index(ALT,AST,TBIL)changes,virological breakthrough rate,adverse drug reactions,etc.,at 12 th week,24 th week,and 48 th week of sequential IFNα-2b treatment。Data analysis was performed using SPSS 22.0 software,and the difference was statistically significant at P < 0.05.ResultsIn the NAs-resistant group and the NAs partial virological response group,the virological response rate,HBsAg negative conversion rate,HBeAg negative conversion rate,and HBeAg seroconversion rate at the 12 th week of treatment were 53.3% and 40%,6.6% and 0%,17.4% and 0%,0% and 0%,respectively;virological response rate,HBsAg negative conversion rate,HBeAg negative conversion rate,HBeAg seroconversion rate at 24 weeks of treatment were 60% and 47%,10% and 0%,26% and 0%,4.3% and 0%;virological response rate,HBsAg negative conversion rate,HBeAg negative conversion rate,HBeAg seroconversion rate at 48 weeks of treatment were 50% and 53%,13.3%,And 0%,26% and 36.4%,4.3% and 18.2%;there was no significant difference in the efficacy between the two groups(P>0.05).In the NAs-resistant group and the NAs-partial virological response group,the HBV DNA quantification of the patients at 12 weeks,24 weeks,and 48 weeks was significantly different from the baseline value.(P<0.05);There was no significant difference in HBV DNA quantification between the 12 th week,24 th week and 48 th week(P>0.05).In the NAs-resistant group and the NAs partial virological response group,there was no significant difference in the ALT,AST,and TBIL between the groups before treatment,12 weeks,24 weeks,and 48 weeks(P>0.05).In the NAs-resistant group,the virological response rates of HBeAg-positive group and HBeAg-negative group at 12 weeks,24 weeks,and 48 weeks were 52.1% and 57.1%,56.5% and 71.4%,43.5% and 71.4%,respectively,the HBsAg negative conversion rate was 4.3% and 14.2%,8.6% and 14.2%,8.6% and 28.5%;there were no statistically significant differences between the two groups(P>0.05).In the NAs complete response group,the HBsAg negative rate,virological breakthrough rate,ALT abnormal rate,and AST abnormal rate were 12.5%,12.5%,18.6%,and 12.5% in the patients with NAs.there was no significant difference in the ALT and TBIL between the groups before treatment,12 weeks,24 weeks,and 48 weeks.(P>0.05).,The difference in AST was statistically significant(P<0.05).The virological breakthrough rates of patients with NAs resistance group,NAs partial virological response group,and NAs complete response group at 48 weeks were 22.2%,14.3%,and 12.5%,respectively,and the difference was not statistically significant(P>0.05).There were no serious adverse drug side reactions during the whole treatment,and no serious adverse events such as liver failure after NAs were stopped.Conclusion(1)IFNα-2b sequential NAs can achieve certain curative effect and good safety in patients with CHB.(2)IFNα-2b sequential NAs can be safely discontinued during treatment of patients with CHB.(3)IFNα-2b sequential NAs treatment can be used as one of the optimized antiviral treatment options for patients with NAs resistance and partial virological response to CHB.