Undetectable HBV DNA at month 12 of entecavir treatment predicts maintained vira

StephenW

Aliment Pharmacol Ther. 2012 Apr 16. doi: 10.1111/j.1365-2036.2012.05098.x. [Epub ahead of print]
Undetectable HBV DNA at month 12 of entecavir treatment predicts maintained viral suppression and HBeAg-seroconversion in chronic hepatitis B patients at 3 years.Wong GL, Wong VW, Chan HY, Tse PC, Wong J, Chim AM, Yiu KK, Chu SH, Chan HL.
SourceInstitute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, China; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.

Abstract
BACKGROUND: On-treatment monitoring of serum hepatitis B virus (HBV) DNA to guide treatment strategy for patients on entecavir has received little attention.
AIM: To investigate the predictive value of on-treatment HBV DNA levels for responses to entecavir.
METHODS: This was a retrospective cohort study among nucleos(t)ide analogue-naïve HBV-infected patients on entecavir with a minimum follow-up of 2 years. Maintained virological suppression was defined as undetectable HBV DNA (<20 IU/mL) until the last visit. Genotypic drug resistance was screened by using the INNO-LiPA DR assay.
RESULTS: A total of 440 chronic hepatitis B patients (160 HBeAg-positive) followed for 34 ± 9 months were included. The cumulative probability of maintained virological suppression at year 1, 2 and 3 were 76.5%, 83.0% and 88.3% respectively. On multivariate analysis, lower baseline HBV DNA, undetectable HBV DNA at month 12 and negative HBeAg were the independent predictors of maintained virological suppression. M12 responders (who had undetectable HBV DNA at month 12) had higher probability of maintained virological suppression at 3 years (99.1%) as compared to non responders (57.5%; P < 0.001). The cumulative probability of HBeAg-seroconversion at year 1, 2 and 3 were 19.0%, 27.2% and 33.5% respectively. M12 responders had higher probability of HBeAg-seroconversion at 3 years (43.2%) than the non responders (19.0%; P = 0.003). M12 responders had lower probability of drug resistance at 3 years (0%) than the non responders (2.6%; P = 0.004).
CONCLUSION: Month 12 HBV DNA responses could predict the probability of maintained virological suppression, HBeAg-seroconversion and risk of drug resistance among patients on entecavir treatment at 3 years.

StephenW

aliment药理疗法。 2012年4月16日。 DOI：10.1111/j.1365-2036.2012.05098.x。 [出处提前打印]
个月时HBV DNA检测不到的恩替卡韦治疗12预测维持在3年的慢性乙型肝炎患者的病毒抑制和e抗原转阴。
黄GL，黄大众，陈HY，谢PC，黄J，詹上午，耀KK，楚SH，陈HL。
源

消化疾病研究所，中文大学，香港特区，中国香港，中国香港特区，香港中文大学内科及药物治疗部。
抽象
背景：

治疗血清乙型肝炎病毒（HBV）DNA的监测，以指导患者对恩替卡韦治疗策略已经很少受到关注。
目的：

为了探讨恩替卡韦在治疗HBV DNA水平的预测值。
方法：

这是一个回顾性队列研究在核苷（酸）IDE模拟天真HBV感染患者对恩替卡韦2年的最低后续。保持病毒学抑制，检测不到乙肝病毒DNA（<20 IU / mL）的定义为，直到最后一次访问。筛选使用INNO-LIPA DR检测基因型耐药。
结果：

共有440慢性乙型肝炎患者34（160 HBeAg阳性）±9个月被列入。累计概率维持在1年的病毒学抑制，2和3分别为76.5％，83.0％和88.3％。多变量分析显示，基线HBV DNA，不到在12个月及HBeAg阴性乙肝病毒DNA保持病毒学抑制的独立预测因子。 M12的反应（谁曾在12个月不到的HBV DNA）保持病毒学抑制的机率较高，在3年（99.1％）比非应答者（57.5％，P <0.001）。 1年的HBeAg血清转换的累积概率，2和3分别为19.0％，27.2％和33.5％。 M12的反应有较高的HBeAg血清转换的概率在3年（43.2％）比非应答者（19.0％，P = 0.003）。 M12的反应，在3年以上无反应（2.6％，P = 0.004）（0％）耐药性的可能性较低。
结论：

12个月HBV DNA的反应可以预测保持病毒学抑制，e抗原转阴，恩替卡韦治疗的患者在3年耐药性的风险概率。