Abstract：Objective: To explore the efficacy of Peg-interferon α-2a (Peg-IFNα-2a) combined with adefovir dipivoxil (ADV) on HbeAg-positive chronic hepatitis B patients with high viral load. Methods: 132 cases of HbeAg-positive chronic hepatitis B patients with high viral load were randomly divided into interferon group, ADV group and combined group, with 44 cases in each group. Interferon group was administered Peg-IFNα-2a, and ADV group was administered ADV, and combined group was firstly treated with ADV to control the reduction of viral load, and then Peg-IFNα-2a was administered additionally. Hepatitis B virus marker conversion, serological marker conversion, virological and serological response after 48 w of treatment, levels of serum interferon-γ (INF-γ) and interleukin-10 (IL-10) before treatment and after 48 w of treatment were observed among the three groups. Results: The alanine aminotransferase (ALT) reversion rate, HBV-DNA negative conversion rate and HBsAg negative conversion rate in combined group were significantly higher than those in interferon group and ADV group (P<0.0167), and the HBeAg seroconversion rate was significantly higher than that in ADV group (P<0.0167), and the differences among the three groups were statistically significant (P<0.0167). The complete virological response rate in combined group was significantly higher than that in interferon group and ADV group (P<0.0167) while the non-response rate was significantly lower than that in interferon group and ADV group (P<0.0167), and there were statistically significant differences among the three groups in the improvement of virological and serological response (P<0.05). After treatment, the INF-γ level in the three groups was significantly increased (P<0.05) while the IL-10 level was significantly decreased (P<0.05), and the changes in combined group were significantly greater than those in interferon group and ADV group (P<0.05). There were no statistically significant differences in the incidence rates of influenza-like symptoms, insomnia, alopecia, neutropenia and platelet count reduction between combined group and interferon group (P>0.0167), and the incidence rates were significantly higher than those in ADV group (P<0.0167). Conclusion: Peg-IFNα-2a combined with ADV for HbeAg-positive chronic hepatitis B patients with high viral load can improve ALT reversion rate, HBV-DNA negative conversion rate, HBsAg negative conversion rate and HBeAg seroconversion rate, and it is conducive to inhibiting viral replication capacity and virological and serological response rates, thus it can be safely promoted in the clinical practice.
周娟, 张文芳. Peg-IFNα-2a联合ADV治疗对高病毒载量e抗原阳性乙肝的疗效观察[J]. 河北医学, 2021, 27(8): 1394-1399.
ZHOU Juan, ZHANG Wenfang. Efficacy of Peg-IFNα-2a Combined with ADV on Hepatitis B Virus E Antigen-Positive Chronic Hepatitis B with High Viral Load. HeBei Med, 2021, 27(8): 1394-1399.
2021, Vol. 27 
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