慢性乙型病毒性肝炎应答预测因子研究进展

杨 桂兰1, 安纪 红*2
1、内蒙古医科大学内蒙古临床医学院
2、内蒙古医科大学内蒙古自治区人民医院

摘要


慢性乙型肝炎（Chronic Hepatitis B，CHB）的抗病毒治疗方向已从长期病毒学抑制转向追求临床治愈（Clinical Cure，CC）。鉴于现有核苷（酸）类似物（Nucleos（t）ide Analogues，NAs）单药治疗难以清除乙型肝炎表面抗原，聚乙二醇干扰素的联合或序贯策略成为当前打破疗效瓶颈的核心路径。由于CC的实现呈现出个体异质性，因此本综述旨在结合近年研究进展，对影响CHB临床治愈的基线因素及治疗过程中的早期应答预测因子进行系统梳理与阐述。

关键词


慢性乙型肝炎；临床治愈；预测因子

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参考


[1]Forbes C, Lavoie L, Satram S, et al. Global importance of new treatment strategies to efforts to control hepatitis B virus [J]. Expert Review of Anti-infective Therapy, 2023,21:8, 847-862.

[2]Hume SJ, Hall S, Burns G, et al. Long‐Term Follow‐Up of Patients in a Prospective Study of NA Discontinuation Identifies Different Patterns of HBsAg Loss [J]. Alimentary Pharmacology & Therapeutics, 2026, 63(2): 231-241.

[3]中华医学会肝病学分会.扩大慢性乙型肝炎抗病毒治疗的专家意见[J].中华肝脏病杂志，2022，30（02）：131-136.

[4]Jiang B, Guan G, Zhao K, et al. Mechanisms underlying delayed loss of HBeAg and HBV DNA following HBsAg seroclearance in PEG-IFNα treated patients of chronic hepatitis B [J]. Emerging Microbes & Infections, 2025, 14(1): 2475847.

[5]Li M, Sun F, Bi X, et al. Consolidation treatment needed for sustained HBsAg-negative response induced by interferon-alpha in HBeAg positive chronic hepatitis B patients [J]. Virologica Sinica, 2022, 37(3): 390-397.

[6]Farag MS, van Campenhout MJH, Sonneveld MJ, et al. Addition of PEG-interferon to long-term nucleos(t)ide analogue therapy enhances HBsAg decline and clearance in HBeAg-negative chronic hepatitis B [J]. Journal of Viral Hepatitis, 2024, 31(4): 193-201.

[7]Marcellin P, Ahn SH, Chuang WL, et al. Predictors of response to tenofovir disoproxil fumarate plus peginterferon alfa-2a combination therapy for chronic hepatitis B [J]. Alimentary Pharmacology & Therapeutics, 2016, 44(9): 957-966.

[8]Bazinet M, Anderson M, Pântea V, et al. Analysis of HBsAg Immunocomplexes and cccDNA Activity During and Persisting After NAP‐Based Therapy [J]. Hepatology Communications, 2021, 5(11): 1873-1887.

[9]Cao Z, Liu Y, Ma L, et al. A potent hepatitis B surface antigen response in subjects with inactive hepatitis B surface antigen carrier treated with pegylated‐interferon alpha [J]. Hepatology, 2017, 66(4): 1058.

[10]Corti D, Benigni F, Shouval D. Viral envelope-specific antibodies in chronic hepatitis B virus infection [J]. Current Opinion in Virology, 2018, 30: 48-57.

[11]Wong D, Littlejohn M, Yuen L, et al. HBeAg levels at week 24 predict response to 8 years of tenofovir in HBeAg-positive chronic hepatitis B patients [J]. Alimentary Pharmacology & Therapeutics, 2018, 47(1): 114-122.

[12]Ghany MG, Buti M, Lampertico P, et al. Guidance on treatment endpoints and study design for clinical trials aiming to achieve cure in chronic hepatitis B and D: Report from the 2022 AASLD-EASL HBV-HDV Treatment Endpoints Conference [J]. Journal of Hepatology, 2023, 79(5): 1254-1269.

[13]Farag MS, Van Campenhout MJH, Pfefferkorn M, et al. Hepatitis B Virus RNA as Early Predictor for Response to Pegylated Interferon Alpha in HBeAg-Negative Chronic Hepatitis B [J]. Clinical Infectious Diseases, 2021, 72(2): 202-211.

[14]Lok AS, Zoulim F, Dusheiko G, et al. Hepatitis B cure: From discovery to regulatory approval [J]. Journal of Hepatology, 2017, 67(4): 847-861.

[15]Fujita K, Mimura S, Iwama H, et al. Serum miRNAs Predicting Sustained HBs Antigen Reduction 48 Weeks after Pegylated Interferon Therapy in HBe Antigen-Negative Patients [J]. International Journal of Molecular Sciences, 2018, 19(7): 1940.

[16]Cao X, Hu Q, Xu W, et al. Kinetics changes in total cholesterol predict HBeAg seroconversion in chronic hepatitis B patients treated with pegylated interferon-alfa [J]. Journal of Viral Hepatitis, 2023, 30(4): 310-318.

[17]Huang D, Wu D, Wang P, et al. End-of-treatment HBcrAg and HBsAb levels identify durable functional cure after Peg-IFN-based therapy in patients with CHB [J]. Journal of Hepatology, 2022, 77(1): 42-54.

[18]Terrault NA, Sterling R, Lok AS, et al. Hepatitis B Virus RNA as a Biomarker for Safe Antiviral Discontinuation: A Prospective Study of Nucleos(t)ide Analogue Withdrawal [J]. The Journal of Infectious Diseases, 2025, 231(5): 1290-1298.


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