Analysis Of Clinical Characteristics Of 45 Patients With Onychomycosis-like Manifestations In The Treatment Of Chronic Hepatitis B With Interferon Alpha-2b

Objective:To investigate the clinical characteristics of 45 cases of onychomycosis-like adverse reactions in chronic hepatitis B(CHB)treated with Interferon alpha-2b(IFNα-2b).Method:1.A total of 45 cases of onychomycosis-like adverse reactions were collected from 2327 CHB patients treated with IFNα-2b in the Second Affiliated Hospital of Nanchang University during 2005 to 2020.2.The first occurrence time of onychomycosis-like adverse reactions and the evolution of the adverse reactions in 45 CHB patients were collected.Antiviral efficacy indicators of IFNα-2b treatment at 12,24,36,48,60,72,84,and 96 weeks were also collected,including blood routine,hepatitis B virus markers,hepatitis B virus deoxyribonucleic acid(HBV DNA),albumin(ALB),total bilirubin(TBIL),aspartate aminotransferase(AST),alanine aminotransferase(ALT),alpha-fetoprotein(AFP),thyroid function,blood glucose,ultrasonography,transient elastography,etc.3.The 45 patients with onychomycosis-like manifestations during the treatment of CHB with IFNα-2b were analyzed for the time characteristics of adverse reactions,the range of nail involvement,the characteristics of nail lesions,the outcome of nail lesions and the effect of CHB treatment.Results:1.The incidence of onychomycosis-like adverse reactions in the treatment of CHB with IFNα-2b is about 1.93%,nail lesions appeared for the first time in the 2 to72 weeks after treatment,and the lesions could appear on any finger or toenail for the first time.2.The occurrence of onychomycosis-like adverse reactions has no effect on blood biochemical examination and limb function,and IFNα-2b treatment can be continued under close observation.In the follow-up treatment,the adverse reactions of 6 patients with nail lesions healed by themselves.However,in the other 39 patients,the nail lesions were aggravated to a certain extent and the number of involved nails increased.The nail lesions of all patients recovered spontaneously during 4 to 48 weeks after IFNα-2b was stopped.3.CHB patients with onychomycosis-like manifestations had better viral response,higher HBV DNA negative conversion rate,hepatitis B e antigen(HBe Ag)negative conversion rate,and HBe Ag seroconversion rate.Conclusion:1.Rare onychomycosis-like adverse reactions may occur during the treatment of CHB with IFNα-2b.2.The occurrence of onychomycosis-like adverse reactions does not affect the treatment plan for CHB,and IFNα-2b treatment can be continued under close observation of the condition.Although the adverse reactions of nail lesions may be aggravated and the number of affected nails will increase,any treatment or special treatment is not required.Nail lesions healed spontaneously after discontinuation of IFNα-2b.3.The occurrence of adverse reactions with onychomycosis-like manifestations may suggest that this type of CHB patients has better efficacy of antiviral therapy.