[1]China-Japan Union Hospital, Jilin University, Changchun, Jilin Province, China.
Background: To investigate the efficacy of individualized therapy with PEG-IFNα-2a and the effect of antiviral therapy on hepatic histology in chronic hepatitis B patients. Methods: 178 Antiviral-naïve hepatitis B patients received subcutaneous Peg-IFNα-2a treatment (180 μg weekly) with an individualized regimen based on response at 12 weeks. Subjects not achieving early response received nucleoside combination therapy, or 48-week treatment; 38 subjects underwent hepatic histological examinations before and after treatment. Result: With combination treatment (entecavir or adefovir), mean hepatitis B virus (HBV) DNA reduction at 48 weeks of post-treatment follow-up was significantly greater than with conventional treatment; the SVR rate was significantly higher with entecavir (69.4%) and adefovir (71.1%) than with conventional treatment (32.6%, p<0.05). Mean HBsAg reductions at 48 weeks of post-treatment follow-up were significantly greater with combination treatment than with conventional treatment. At 48 weeks of post-treatment follow-up, the improvement rate in hepatic histology was significantly higher with combination (69.2 and 64.3%) than with conventional treatment. Conclusion: adding nucleoside analogs in patients without early response may substantially increase the SVR rate and decrease or even seroconvert HBeAg and HBsAg. Long-term antiviral therapy may also improve hepatic histology and delay or prevent disease progression in chronic hepatitis B patients.
(8.0+极速模式)