【摘要】 目的:观察HBsAg致敏患者自体外周血单个核细胞(PBMC)来源的树突状细胞(DC)(简称抗HBV-DC)治疗e抗原阴性慢性乙型肝炎病毒(HBV)感染者的临床效果。方法:4例轻度慢性乙型肝炎(CHB)患者、5例慢性HBV携带者及17例非活动性HBsAg携带者接受临床试验。检测治疗前后HBV标志物定量、HBV-DNA定量及肝功能,两次检测平均间隔40d。结果:治愈5例,好转21例,有效率为100%,治愈率19.23%。治疗前后HBsAg分别为(129.58±112.68)ng/ml和(42.67±51.41)ng/ml(t=5.57,P<0.001),平均下降68%,5例HBsAg转阴。7例治疗前HBV-DNA定量高于正常,为(2.17±5.27)×106copies/ml,治疗后6例下降,其中,5例降为正常,1例升高0.49log;原1例HBV-DNA定量正常者升高到1.30×103copies/ml。治疗前后ALT分别为(30.04±19.99)U/L和(40.50±45.10)U/L,有升高趋势(t=1.75,P=0.09),HBsAb、HBeAb、HBcAb及TBIL无显著变化。结论:抗HBV-DC静脉回输可显著降低并清除HBsAg,抑制e抗原阴性慢性HBV感染者的病毒复制,减少病毒载量,清除病毒,彻底治愈慢性HBV感染者。CHB患者、慢性HBV携带者和非活动性HBsAg携带者均可对抗HBV-DC的治疗发生良好的应答反应,是一种安全、高效地治疗e抗原阴性慢性HBV感染者的方法,显示出良好的临床应用前景。延长疗程和增加治疗次数可望进一步提高治愈率。更多还原

【Abstract】 Objective:To investigate the treatment effect of autologous HBsAg-loaded dendritic cells (anti-HBV DCs) on e antigen negative patients with chronic HBV infection. Methods:4 chronic hepatitis B (CHB) , 5 chronic HBV carrier and 17 inactive HBsAg carrier attended the test. HBV markers, HBV DNA level, and liver function tests in the serum of patients were tested before and after treatment. Results:The effective rate was 100%(26/26), and the cure rate was 19.23%(5/26). The HBsAg levels were (129.58±112.68) ng/ml and (42.67±51.41) ng/ml (t=5.57,P<0.001), and the ALT levels were (30.04±19.99) U/L and (40.50±45.10) U/L(t=1.75,P=0.09)before and after treatment. And 5 patients’HBsAg were negative after treatment. The HBV-DNA levels of 7 patients whose HBV DNA being abnormal before treatment were (2.17±5.27)×106 copy/ml, and 5/7 patients’HBV DNA were negative after treatment.Conclusion:The autologous anti-HBV DCs can effectively suppress HBV replication, reduce and eliminate HBV and HBsAg, and cure those e antigen negative patients with chronic HBV infection. CHB, chronic HBV carrier and inactive HBsAg carrier also have a more effective and more safety for anti-HBV DCs treatment. The cure rate may raise a further for extending period of treatment and increasing times of treatment.更多还原