聚乙二醇干扰素α-2a与聚乙二醇干扰素α-2b治疗慢性乙型肝炎的效果及安全性比较

Objective To investigate the clinical effect and safety of pegylated interferon-α-2a (PEG-IFN-α-2a) versus pegylated interferon-α-2b (PEG-IFN-α-2b) in the treatment of chronic hepatitis B (CHB). Methods The CHB patients who were treated with PEG-IFN-α-2a (180 μg/week) or PEG-IFN-α-2b (180 μg/week) in Department of Infectious Diseases in our hospital from January 2017 to June 2018 were enrolled. The two groups were compared in terms of the levels of HBsAg, HBV DNA, HBeAg, and alanine aminotransferase (ALT) at 4, 12, 24, and 48 weeks of treatment, and the indices for antiviral effect at 48 weeks were used as main outcome measures. The above indices were compared between response group and non-response group. The independent samples t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. Results There were no significant differences between the PEG-IFN-α-2a group and the PEG-IFN-α-2b group in serum HBV DNA clearance rate (67.6% vs 59.4%, P＞0.05) and HBeAg seroconversion rate (27.2% vs 34.6%, P＞0.05). In the PEG-IFN-α-2a group, the HBV DNA response group had a significantly lower baseline ALT level than the HBV DNA non-response group (Z=2.390, P=0.016); the HBeAg response group had a significantly lower baseline HBeAg level than the HBeAg non-response group (Z=2.286, P=0.021). In the PEG-IFN-α-2b group, the HBV DNA response group had significantly lower baseline HBV DNA level and baseline HBeAg level than the HBV DNA non-response group (Z=2.154 and 2.057, P=0.030 and 0.041); the HBeAg response group had a significantly lower baseline HBV DNA level than the HBeAg non-response group (Z=2.052, P=0.042). There were no significant differences in the incidence rates of adverse reactions between the two groups (P＞0.05); in the PEG-IFN-α-2b group, one patient experienced Purtscher’s retinopathy and one experienced thrombocytopenia, while no similar adverse reactions were observed in the PEG-IFN-α-2a group. Conclusion Both PEG-IFN-α-2a and PEG-IFN-α-2b have strong antiviral and immunomodulatory effects in the treatment of CHB, with similar clinical effect and safety. [ABSTRACT FROM AUTHOR]