目的 探讨聚乙二醇干扰素α-2a(Peg-IFNα2a)联合恩替卡韦(ETV)治疗HBeAg阴性慢性乙型肝炎(CHB)48周的疗效及安全性.方法 回顾性纳入2013年6月至2015年6月在首都医科大学附属北京佑安医院接受Peg-IFNα2a(135μg/周)联合ETV(0.5 mg/d)治疗的50例初治HBeAg阴性CHB患者,收集基线和治疗过程中每12周的临床数据,包括HBV DNA和HBsAg水平等,分析48周HBV DNA不可检测率、HBsAg清除率及不良反应发生情况.结果 Peg-IFNα2a联合ETV治疗48周,全部患者HBV DNA低于检测值(<20 IU/mL);HBsAg清除率及血清学转换率分别为24%和16%.不良反应主要表现为发热、乏力、脱发、食欲下降、皮疹和甲状腺功能减退,给予对症及支持治疗,均可继续原方案.结论 Peg-IFNα2a联合ETV可提高HBeAg阴性CHB的HBsAg清除率,且安全性良好,是值得探索的优化治疗策略之一.%Objective To investigate the efficacy and safety of peginterferon alfa-2a (Peg-IFNα2a) combined with entecavir (ETV) in treatment of patients with hepatitis B surface antigen (HBeAg)-negative chronic hepatitis B (CHB) for 48weeks. Methods A total of 50 consecutive patients with HBeAg-negative CHB who received Peg-IFNα2a (135μg/weeks) combined with ETV in Beijing You'an Hospital, Capital Medical University from June 2013 to June 2015 were enrolled. Clinical data (including HBV DNA and HBsAg levels) were collected at 12-week intervals throughout the treatment course. HBV DNA undetectable rate, HBsAg clearance rate and adverse reactions were ana-lyzed. Results For all patients, the 48-week treatment of Peg-IFNα2a combined with ETV reduced the level of HBV DNA below the detection threshold (<20 IU/mL). The rates of HBsAg clearance and seroconversion were 24%and 16%, respectively. Adverse reactions mainly manifested as fever, fatigue, hair loss, loss of appetite, skin rash and hypothyroid-ism, which were relieved after symptomatic and supportive treatment. Conclusion Peg-IFNα2a combined with ETV can improve the HBsAg clearance rate of HBeAg-negative CHB, and has a good safety, which appears to be a promising treatment strategy.
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