HBsAg-SEROKONVERZIJA U LIJEČENJU KRONIČNOG HEPATITISA B PEGILIRANIM INTERFERONOM

Lejla Čalkić, Lejla Bajramović-Omeragić, Azra Husić-Selimović, Ibrahim Aličković

Idealni cilj antivirusne terapije ili izlječenje kroničnog hepatitisa B jesu gubitak HBsAg i HBsAg-serokonverzija. Prema suvremenim smjernicama svih udruga za bolesti jetre, pegilirani interferon alfa-2a i nukleoz(t)idni analozi (entekavir, tenofovir) prvi su izbor u liječenju kroničnog hepatitisa B. Cilj je rada bio ocijeniti uspjeh terapije bolesnika s kroničnim hepatitisom B, koji su primali pegilirani interferon. Na kraju desetogodišnjeg perioda HBV DNK < 50 IU/mL i HBsAg-serokonverziju postigla su 4 (4/55; 7,00%) bolesnika. Svi su bili HBeAg-negativni. Dodatno je prikazan slučaj bolesnika koji je nakon terapije imao najkraći period izlječenja. Bolesnik je muškarac, u dobi od 47 godina, s novootkrivenim HBeAg-negativnim kroničnim hepatitisom B i izraženom aktivnošću serumskih aminotransferaza. Liječen je pegiliranim interferonom alfa-2a, 180 µg jednput na tjedan, tijekom 48 tjedana. Nakon antivirusne terapije bolesnik je HBV DNK negativan, HBsAg-negativan i urednih aminotransferaza, a 12 mjeseci nakon završetka antivirusne terapije dolazi do HBsAg-serokonverzije. Stupanj izlječenja kroničnog hepatitisa B, nažalost, ni do danas ne zadovoljava potpuno, s izuzetkom rijetkih, pojedinačnih slučajeva.

The ideal goal of antiviral therapy or cure of chronic hepatitis B is HBsAg clearance and HBsAg seroconversion. According to modern guidelines of all Associations for liver diseases pegylated interferon alfa-2a and nucleos(t)ide analogues (entecavir, tenofovir) are first choice in the treatment of chronic hepatitis B. The aim of the study was to evaluate the success of the treatment of patients with chronic hepatitis B who received pegylated interferon. At the end of ten year period, HBV DNA <50 IU/ml and HBsAg seroconversion achieved 4 (4/55, 7.00%) patients. All were HBeAg negative. Additionally, is presented the case of patients, who, after the treatment, had the shortest period of healing. Patient is a man, aged 47 years, with the newly discovered HBeAg negative chronic hepatitis B and pronounced activity of serum aminotransferases. He was treated with pegylated interferon alfa-2a, 180 µg once a week, for 48 weeks. After antiviral therapy, the patient is HBV DNA negative, HBsAg negative and neat aminotransferases, and 12 months after completion of antiviral therapy comes to HBsAg seroconversion. The degree of cure of chronic hepatitis B, unfortunately, has not been entirely satisfactory, with the exception of the few individual cases.