期刊
VIRAL IMMUNOLOGY
卷 35, 期 1, 页码 71-75出版社
MARY ANN LIEBERT, INC
DOI: 10.1089/vim.2021.0112
关键词
chronic hepatitis B; Peg interferon; NAs; combination therapy; clinical cure; intermittent therapy
资金
- Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support [XMLX 201706, XMLX 202127]
- Digestive Medical Coordinated Development Center of Beijing Hospitals Authority [XXZ0302, XXT28]
Combination therapy of interferon and nucleoside (nucleotide) analogs has been shown to effectively inhibit viral replication in chronic hepatitis B patients. In this case study, a patient with a poor response to tenofovir monotherapy achieved HBsAg clearance after receiving pegylated interferon alfa-2a combination therapy. Continued viral suppression and seroconversion of important markers were observed during and after consolidation therapy.
Interferon (IFN) and nucleoside (nucleotide) analogs (NAs) are two effective antiviral drugs for chronic hepatitis B (CHB). More and more evidence shows that the combination of the two drugs can better inhibit viral replication and even achieve clinical cure. IFN intermittent therapy is also considered to be an important measure to resolve IFN fatigue when hepatitis B surface antigen (HBsAg) decline appears stagnated during IFN-based antiviral therapy. A 36-year-old male NA-experienced patient with hepatitis B e antigen (HBeAg)-positive CHB was admitted to our hospital. After a poor response to tenofovir disoproxil fumarate (TDF) monotherapy for 1 year, the patient was treated with pegylated interferon alfa-2a combination therapy and finally achieved HBsAg clearance. During the treatment and follow-up, HBsAg, HBeAg, hepatitis B virus (HBV) DNA, and serum alanine aminotransferase, etc. were monitored every 3 months. Between weeks 58 and 71 of combination therapy, IFN was discontinued because of a slow decline in HBsAg, and TDF alone was used for maintenance therapy. Complete virological response, HBeAg and HBsAg seroconversion were observed at weeks 44, 96, and 122, respectively. After 24 weeks of consolidation therapy, HBsAg, HBeAg, and HBV DNA were consistently negative, and hepatitis B surface antibody was 729.30 mIU/mL at week 146 of the combination therapy, then we stopped drugs. Following up after 28 weeks of cessation therapy, the patient still remained clinically cured.
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