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

doi:10.3969/j.issn.1006-5725.2026.08.011

Abstract

Abstract:

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.

Key words: chronic hepatitis B, pegylated interferon alpha, advantageous individuals, hepatitis B surface antigen, predictors

CLC Number:

R512.6⁺2

Sisi CHEN,Yuting LI,Yan YAN. Research progress on predictive indicators for the efficacy of pegylated interferon alpha in the treatment of chronic hepatitis B[J]. The Journal of Practical Medicine, 2026, 42(8): 1379-1387.

Figures/Tables 1

References 65

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预测因素	与应答的关系	证据强度
年龄	复杂，非线性。较年轻（尤其儿童）与更高HBsAg清除率相关；青壮年（30 ~ 40岁）可能与更高HBeAg血清学转换率相关。	强（多中心、大样本及荟萃分析^{[2, 6-7]}支持）
性别	不明确或影响微弱。部分研究提示女性可能占优，但多数大样本研究未显示显著差异。	弱/存在争议^[10-11]
基线ALT水平	治疗前ALT较高（通常> 2 × ULN）是良好应答的独立预测因子。	强（多项研究^[13,15]一致证实）
宿主遗传多态性（如 IL28B）	正向预测。有利基因型（如rs12979860 CC）与更高应答率相关。	强（遗传学研究^[16-18]证实）
肝纤维化/肝硬化程度	不良反应风险正相关；应答率存在争议，代偿期肝硬化仍有较高病毒学应答率。	弱/存在争议^[28-30]

Research progress on predictive indicators for the efficacy of pegylated interferon alpha in the treatment of chronic hepatitis B

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