核苷酸类似物联合类固醇脉冲治疗急性HBV感染可有效促进HBV清除

IF 1.5 Q3 GASTROENTEROLOGY & HEPATOLOGY
T. Goya, Tomoyuki Kurashige, M. Kurokawa, Masatake Tanaka, Tomomi Aoyagi, Motoi Takahashi, K. Imoto, S. Tashiro, Hideo Suzuki, Masaki Kato, M. Kohjima, Y. Ogawa
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引用次数: 0

摘要

急性乙型肝炎病毒(HBV)感染偶尔会发展为急性肝衰竭,通常预后不佳。适当的药理学方法尚待确定。尽管核苷酸类似物(NA)和皮质类固醇是治疗急性HBV感染的候选药物,但其治疗效果,尤其是对HBV清除率的影响,仍不清楚。为了阐明NA和类固醇脉冲疗法(SPT)联合治疗急性HBV感染对HBV清除率的影响,我们首先分析了该疗法与NA单一疗法(NAM)相比对HBV感染患者的有效性。在2007年5月至2018年12月连续57名急性乙型肝炎感染患者中,我们纳入了25名患者参与本研究,我们对他们进行了随访,直到HBV清除。根据NA和SPT的给药,我们将患者分为两组(NAM组和NA+SPT组),并比较其结果。在25名患者中,10名接受NAM治疗,15名接受NA+SPT治疗。SPT没有明显的不良反应。清除HBsAg(76(43–116)天vs.26(14–51)天,p=0.0418)和HBV-DNA(NAM组vs.NA+SPT组:180(83.5–220)vs.69(43–136)天,p=0.0420)所需时间在NA+SPT中明显短于NAM组。NA+SPT对HBsAg和HBV-DNA清除的危险比分别为0.45(0.19-1.09)和0.35(0.14-0.89)。总之,我们发现NA+SPT促进了HBV的消除。这些发现支持使用NA+SPT组合治疗急性HBV感染,而无需担心持续的HBV感染。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Combination of Nucleotide Analog Therapy and Steroid Pulse Therapy for Acute HBV Infection Effectively Promotes HBV Clearance
Acute hepatitis B virus (HBV) infection occasionally progresses to acute liver failure, often with poor prognosis. The appropriate pharmacological approach is yet to be established. Although nucleotide analogs (NA) and corticosteroids are candidates for the treatment of acute HBV infection, their therapeutic effects, especially their effect on HBV clearance, remain unclear. To clarify effects on the HBV clearance of combination therapy of NA and steroid pulse therapy (SPT) for acute HBV infection, we first analyze the effectiveness of this therapy in patients with HBV infection compared with NA monotherapy (NAM). Of the 57 consecutive patients with acute hepatitis B infection from May 2007 to December 2018, we have included 25 patients for this study, whom we followed up until HBV clearance. According to the administration of NA and SPT, we divided patients into two groups (NAM group and NA + SPT group) and compared their results. Of the 25 patients, 10 received NAM, whereas 15 received NA + SPT. There were no appreciable adverse effects related to SPT. The time required for the clearance of HBsAg (76 (43–116) days vs. 26 (14–51) days, p = 0.0418) and HBV-DNA (NAM group vs. NA + SPT group: 180 (83.5–220) vs. 69 (43–136) days, p = 0.0420) was significantly shorter in the NA + SPT group than in the NAM group. The hazard ratio of NA + SPT for the clearance of HBsAg and HBV-DNA were 0.45 (0.19–1.09) and 0.35 (0.14–0.89), respectively. In conclusion, we showed that NA + SPT promoted HBV elimination. These findings support the use of the NA + SPT combination for acute HBV infection without the concern of persistent HBV infection.
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来源期刊
Gastroenterology Insights
Gastroenterology Insights GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
2.80
自引率
3.40%
发文量
35
审稿时长
10 weeks
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