- 现金
- 62111 元
- 精华
- 26
- 帖子
- 30437
- 注册时间
- 2009-10-5
- 最后登录
- 2022-12-28
|
自发乙肝e抗原血清学转换是与无后续抗病毒治疗乙型肝炎表面抗原转阴率较高
TITLE: Spontaneous hepatitis B e-antigen seroconversion without subsequent antiviral therapy is associated with higher rates of hepatitis B surface antigen seroclearance
AUTHORS (FIRST NAME, LAST NAME): James Fung1, Danny Wong1, Wai-Kay Seto1, Ching-Lung Lai1, Man-Fung Yuen1
Institutional Author(s):
INSTITUTIONS (ALL): 1. Medicine, University of Hong Kong, Hong Kong, China.
ABSTRACT BODY: Background: In chronic hepatitis B (CHB), the implications of hepatitis B e-antigen (HBeAg) seroconversion on subsequent hepatitis B surface antigen (HBsAg) seroclearance has not been documented.
Methods: The Chronic Hepatitis B E-Seroconversion Study (C.H.E.S.S.) cohort follows up a large population of CHB patients with documented HBeAg seroclearance. Patients are followed-up at 3-6 monthly intervals with routine liver biochemistry and viral serological tests.
Results: A total of 803 patients with documented HBeAg seroconversion were included, with a median HBeAg seroconversion age of 34 years. The median follow-up length was 123 months after HBeAg seroclearance, with a total of 9250 patient-years. Of these, 502 (62.5%) were male. The cumulative rate of HBsAg seroclearance after HBeAg seroconversion was 0.2%, 1.4%, 3%, and 15% after 1, 5, 10, and 20 years respectively, without any gender differences (p=0.756). The median time to HBsAg seroclearance after HBeAg seroconversion was 139 months. 448 (55.8%) remained treatment-naïve after spontaneous HBeAg seroconversion (group 1), 204 (25.4%) had treatment-induced HBeAg seroconversion (group 2), and 151 (18.8%) required antiviral treatment after spontaneous HBeAg seroconversion. The HBsAg seroclearance rate observed in groups 1, 2, and 3 at 10 years were 4.3%, 2.6%, and 0% respectively, and at 20 years were 24%, 7.2%, and 0% respectively (p<0.001) (see figure). No HBsAg seroclearance was observed for group 3. The age of spontaneous HBeAg seroconversion was lower in group 1 compared with group 3 (32 vs 39 years respectively, p<0.001).
Conclusion: In CHB, early spontaneous HBeAg seroconversion is associated with lesser chance of active HBeAg-negative disease and higher chance of HBsAg seroclearance. HBsAg seroclearance is rare for those who spontaneously undergo HBeAg seroconversion with subsequent reactivation requiring antiviral therapy.
|
|