Impacts of PEG-IFN-α-2b Combination Therapy on Liver Function, Immune Factors and Risk Factors in Patients With HBV Infection: A Retrospective Study.

IF 1 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL
British journal of hospital medicine Pub Date : 2025-04-25 Epub Date: 2025-04-15 DOI:10.12968/hmed.2024.0850
Jun Zhang, Jing Zhou
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引用次数: 0

Abstract

Aims/Background Hepatitis B virus (HBV) infection poses a challenge to global healthcare. Peginterferon alfa-2b (PEG-IFNα-2b) is an effective treatment for HBV infection. This study aimed to explore the efficacy of PEG-IFNα-2b combined with entecavir in the treatment of HBV infection, its effect on liver function and immune factors, and the risk factors affecting the prognosis of patients with HBV infection. Methods The clinical data of 184 patients with HBV infection who were treated at Jinhua Central Hospital from January 2021 to January 2024 were collected for retrospective analysis. Patients were divided into a control group (not receiving antiviral treatment, n = 34), a standard treatment group (receiving entecavir, n = 85), and a combination treatment group (PEG-IFNα-2b and entecavir, n = 65) according to the treatment approach. Treatment efficacy, liver function indicators (albumin [ALB], alanine aminotransferase [ALT], and aspartate aminotransferase [AST]), immune factor indexes (tumour necrosis factor alpha [TNF-α] and interferon gamma [IFN-γ]), hepatitis B surface antigen [HBsAg] and HBV DNA levels were compared among the three groups. All patients were followed up after treatment. According to their prognosis, the patients were divided into good prognosis group (n = 118) and poor prognosis group (n = 66). Logistic regression analysis was performed to explore the risk factors affecting the prognosis of HBV patients. Results The efficacy in the combination treatment group was higher (92.31%) than that in the control group (8.82%) and the standard treatment group (78.82%) (p < 0.05). After treatment, the HBsAg and HBV DNA levels were decreased in the standard treatment and combination treatment groups (p < 0.05). Compared with the control and standard treatment groups, the combination treatment group exhibited significantly lower HBsAg and HBV DNA levels after treatment (p < 0.05). Besides, the combination treatment group had lower ALT and AST levels (p < 0.05), and higher ALB level (p < 0.05), than the control and standard treatment groups after treatment. Compared with the control and standard treatment groups, the combination treatment group demonstrated decreased TNF-α level and higher IFN-γ level after treatment (p < 0.05). Multivariate logistic regression analysis identified family medical history as the risk factor affecting the prognosis of patients with HBV infection (p = 0.001, odds ratio [OR] = 3.614, 95% confidence interval [CI]: 1.685-7.750) and therapy regimen as the protective factor (p = 0.029, OR = 0.135, 95% CI: 0.022-0.815). Conclusion The PEG-IFNα-2b combination therapy in patients with HBV infection significantly improves the clinical treatment efficacy, liver function, and immune factors. In addition, this study found that therapy regimen and family medical history are independent factors affecting the prognosis of HBV infection.

PEG-IFN-α-2b联合治疗对HBV感染患者肝功能、免疫因素及危险因素影响的回顾性研究
目的/背景乙型肝炎病毒(HBV)感染对全球卫生保健构成挑战。聚乙二醇干扰素α-2b (PEG-IFNα-2b)是治疗HBV感染的有效药物。本研究旨在探讨PEG-IFNα-2b联合恩替卡韦治疗HBV感染的疗效,对肝功能和免疫因子的影响,以及影响HBV感染患者预后的危险因素。方法收集2021年1月至2024年1月金华市中心医院收治的184例HBV感染患者的临床资料进行回顾性分析。根据治疗方法将患者分为对照组(未接受抗病毒治疗,n = 34)、标准治疗组(接受恩替卡韦治疗,n = 85)和联合治疗组(PEG-IFNα-2b +恩替卡韦,n = 65)。比较三组患者的治疗疗效、肝功能指标(白蛋白[ALB]、丙氨酸转氨酶[ALT]、天冬氨酸转氨酶[AST])、免疫因子指标(肿瘤坏死因子α [TNF-α]、干扰素γ [IFN-γ])、乙型肝炎表面抗原[HBsAg]、HBV DNA水平。所有患者治疗后均进行随访。根据患者预后情况将患者分为预后良好组(118例)和预后不良组(66例)。采用Logistic回归分析探讨影响HBV患者预后的危险因素。结果联合治疗组总有效率(92.31%)高于对照组(8.82%)和标准治疗组(78.82%)(p < 0.05)。治疗后,标准治疗组和联合治疗组HBsAg和HBV DNA水平均降低(p < 0.05)。与对照组和标准治疗组比较,联合治疗组治疗后HBsAg和HBV DNA水平显著降低(p < 0.05)。联合治疗组治疗后ALT、AST水平低于对照组(p < 0.05), ALB水平高于对照组和标准治疗组(p < 0.05)。与对照组和标准治疗组比较,联合治疗组治疗后TNF-α水平降低,IFN-γ水平升高(p < 0.05)。多因素logistic回归分析发现,家族史是影响HBV感染患者预后的危险因素(p = 0.001,优势比[OR] = 3.614, 95%可信区间[CI]: 1.685-7.750),治疗方案是影响HBV感染患者预后的保护因素(p = 0.029, OR = 0.135, 95% CI: 0.022-0.815)。结论PEG-IFNα-2b联合治疗HBV感染患者可显著提高临床疗效、肝功能及免疫因子水平。此外,本研究发现治疗方案和家族病史是影响HBV感染预后的独立因素。
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来源期刊
British journal of hospital medicine
British journal of hospital medicine 医学-医学:内科
CiteScore
1.50
自引率
0.00%
发文量
176
审稿时长
4-8 weeks
期刊介绍: British Journal of Hospital Medicine was established in 1966, and is still true to its origins: a monthly, peer-reviewed, multidisciplinary review journal for hospital doctors and doctors in training. The journal publishes an authoritative mix of clinical reviews, education and training updates, quality improvement projects and case reports, and book reviews from recognized leaders in the profession. The Core Training for Doctors section provides clinical information in an easily accessible format for doctors in training. British Journal of Hospital Medicine is an invaluable resource for hospital doctors at all stages of their career. The journal is indexed on Medline, CINAHL, the Sociedad Iberoamericana de Información Científica and Scopus.
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