Hepatitis B surface antigen loss after discontinuing nucleos(t)ide analogue for treatment of chronic hepatitis B patients is persistent in White patients
Suárez, Emilioa; Buti, Maríac; Rodríguez, Manuelf; Prieto, Martíng; Pascasio-Acevedo, Juan M.b; Casanovas, Teresad; Crespo, Javieri; Tapiador, Juan Arenas Ruizj; Gómez-Rodríguez, Rafaelk; Figueruela, Blancaa; Diago, Moisésh; Morillas, Rosa M.e; Zozaya, José M.l; Calleja, José L.m; Casado, Martan; Molina, Esthero; Fuentes, Javierp; Simón, Miguel A.q
European Journal of Gastroenterology & Hepatology: February 2019 - Volume 31 - Issue 2 - p 267–271
doi: 10.1097/MEG.0000000000001289
Original Articles: Hepatology
Abstract
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Objective The objective of this study was to determine the long-term clinical outcome and persistence of hepatitis B surface antigen (HBsAg) loss after discontinuation of treatment.
Background The prognosis of patients with chronic hepatitis B (CHB) treated with nucleos(t)ide analogues (NAs) who discontinue treatment after loss of HBsAg remains largely unknown, particularly in White patients.
Patients and methods We analysed a cohort of patients with CHB who discontinued NA treatment after loss of HBsAg. A total of 69 patients with hepatitis-B-e antigen-positive or hepatitis-B-e antigen-negative CHB with undetectable HBsAg during NA treatment were included after discontinuation of treatment, and followed up for a median period of 37.8 months (interquartile range: 23.8–54.6 months).
Results At the end of follow-up, none of the patients showed spontaneous reappearance of HBsAg and only one patient had detectable hepatitis B virus DNA (22 IU/ml). Another patient negative for HBsAg and anti-HBs developed hepatitis B virus reactivation without elevated transaminases after treatment with corticosteroids and vincristine for dendritic cell neoplasm, 38 months after withdrawal of the antiviral treatment. Regarding clinical outcome, a patient with cirrhosis developed hepatocellular carcinoma, 6.6 years after discontinuing treatment. None of the patients had hepatic decompensation or underwent liver transplantation.
Conclusion HBsAg clearance after discontinuing NAs in patients with CHB is persistent and associated with good prognosis. The risk for developing hepatocellular carcinoma persists among patients with cirrhosis. 作者: StephenW 时间: 2019-1-3 11:10
结果在随访结束时，没有患者表现出HBsAg的自发再现，只有一名患者有可检测到的乙型肝炎病毒DNA（22 IU / ml）。在停用抗病毒治疗38个月后，另一名HBsAg和抗HBs阴性的患者在用皮质类固醇和长春新碱治疗树突状细胞肿瘤后，转换酶升高而乙型肝炎病毒再次激活。关于临床结果，肝硬化患者在停止治疗后6。6年发展为肝细胞癌。没有患者出现肝功能失代偿或肝移植。