THU-215
Association between core mutations and annual decline rate of
HBVDNA and HBsAg in chronic hepatitis B patients treated with
nucleoside analogue
Takashi Honda1, Masatoshi Ishigami1, Takanori Ito1, Yoji Ishizu1,
Teiji Kuzuya1, Mitsuhiro Fujishiro1. 1Nagoya University Graduate School
of Medicine, Gastroenterology and Hepatology, Nagoya, Japan
Email: [email protected]
Background and aims: We have reported that measurement of core
I97L mutation in addition to HBVDNA and ALT levels would be useful
to predict subsequent clinical course in chronic hepatitis B (CHB)
patients. We investigated differences in annual decline rate of
HBVDNA and HBsAg between patients who treated with nucleoside
analogue therapy (NA) therapy (Group NA) and patients who were
observed in the natural history of the disease (Group N). Hepatitis B
core-related antigen (HBcrAg) may serve as useful marker for virus
replication and reflect intrahepatic cccDNA.
Method: One hundred thirty-eight CHB patients who were determined
core I97 were enrolled in this study. Median age of patients
was 42 (male/female = 67/71, Group NA/Group N = 42/96, all patients
had genotype C virus). Median observational period was 7.0 years. 1)
In Group N (n = 96) annual decline rate of HBVDNA and HBsAg were
compared according to presence of core I97L mutation. 2) Among
Group NA (n = 42) annual decline rate of HBVDNA and HBsAg were
compared according to presence of core I97L mutation before NA
therapy. Moreover, HBcrAg at final visit was also compared according
to presence of core I97L mutation.
Results: 1) In Group N annual decline rate of HBVDNA in patients
with I97L was significantly higher than that in patients with I97
wild-type (0.23 log copies/ml/year, 0.05 log copies/ml/year, respectively,
p = 0.036). On the other hand, annual decline rate of HBsAg inpatients with I97L was significantly higher than that in patients with
I97 wild (0.10 IU/ml/year, 0.05 IU/ml/year, respectively, p = 0.003).
Furthermore, the rate of HBsAg loss in patients with I97L was
significantly higher than that in the patients with I97 wild (24.3% vs.
3.6%, respectively, p = 0.002). 2) Among Group NA there was no
significant difference in annual decline rate of HBVDNA and HBsAg.
However, HBcrAg of the patient with I97L was significantly lower
than that of the patients with I97I/Fwild (3.0 logU/ml vs. 3.7 logU/ml,
respectively).
Conclusion: In CHB patients, patients with I97L had significantly
higher annual decline rate of HBVDNA and HBsAg. Patients with I97L
before NA treatment showed significantly lower HBcrAg at final visit.
These results suggest HBcrAg levels would be low in patients who
have I97L mutation before NA therapy.作者: StephenW 时间: 2019-4-4 13:09