收稿日期: 2025-12-20
网络出版日期: 2026-04-28
基金资助
国家自然科学基金项目(81701550);无锡市卫健委中青年拔尖人才资助计划(BJ2023092);无锡市“太湖人才计划”顶尖医学专家团队项目(锡卫人［2025］2号)
Research progress on predictive indicators for the efficacy of pegylated interferon alpha in the treatment of chronic hepatitis B
Received date: 2025-12-20
Online published: 2026-04-28
聚乙二醇干扰素α（pegylated interferon alpha，Peg-IFN-α）具有抗病毒和免疫调节的双重作用，可使部分慢性乙型肝炎（chronic hepatitis B，CHB）患者在有限疗程内实现较高的乙肝病毒表面抗原（hepatitis B virus surface antigen，HBsAg）清除率，为临床治愈提供可能，并降低肝癌风险。然而，该药物存在费用高、不良反应明显及疗效个体差异大等问题，因此，在疗程开始前根据宿主因素及优势指标精准筛选优势人群至关重要。该文综述了影响Peg-IFN-α治疗应答的宿主因素（年龄、性别、基线丙氨酸氨基转移酶水平、干扰素相关基因多态性、肝纤维化程度）与临床病毒学指标（HBV 基因型、病毒突变体、病毒载量、抗原及新型病毒标志物水平），阐明其预测价值及作用机制，分析当前治疗难点并提出个体化策略，为优化CHB临床治疗方案提供参考依据。
陈丝丝 , 李玉婷 , 阎岩 . 聚乙二醇干扰素α治疗慢性乙型肝炎疗效的预测指标相关研究进展[J]. 实用医学杂志, 2026 , 42(8) : 1379 -1387 . DOI: 10.3969/j.issn.1006-5725.2026.08.011
Pegylated interferon alpha （Peg-IFN-α） demonstrates dual antiviral and immunomodulatory properties， which allow a subset of chronic hepatitis B （CHB） patients to attain high hepatitis B surface antigen （HBsAg） clearance rates within a limited treatment period. This， in turn， presents the potential for clinical cure and a reduced risk of hepatocellular carcinoma. Nevertheless， its clinical application is restricted by high costs， significant adverse effects， and considerable inter-individual variability in therapeutic response. This highlights the need for accurate patient stratification. This review systematically assesses host-related factors （including age， gender， baseline alanine aminotransferase levels， interferon-related gene polymorphisms， and hepatic fibrosis status） and virological parameters （such as HBV genotype， viral mutations， viral load， and antigen/novel viral marker levels） that impact Peg-IFN-α treatment outcomes. By clarifying their predictive value and mechanistic roles， analyzing current therapeutic challenges， and suggesting individualized treatment strategies， this work aims to promote the optimization of clinical management protocols for CHB.
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