Sustained Responses and Loss of HBsAg in HBeAg-Negative Patients with Chronic He

StephenW

Gastroenterology. 2012 May 31. [Epub ahead of print]
Sustained Responses and Loss of HBsAg in HBeAg-Negative Patients with Chronic Hepatitis B  Who Stop Long-Term Treatment with Adefovir.Hadziyannis SJ, Sevastianos V, Rapti I, Vassilopoulos D, Hadziyannis E.
SourceDepartment of Medicine and Hepatology, Henry Dunant Hospital, , National and Kapodistrian University of Athens, Athens, Greece; Molecular Biology Laboratory of the Liver Unit at the Evgenidion Hospital , National and Kapodistrian University of Athens, Athens, Greece.

AbstractBACKGROUND & AIMS: Little is known about the biochemical and virologic effects of stopping long-term treatment nucleos(t)ide analogue therapy for hepatitis B e antigen (HBeAg)-negative patients with chronic hepatitis B (CHB).
METHODS: We performed a cohort observational study, following 33 HBeAg-negative patients with CHB, undetectable serum HBV DNA, and normal levels of aminotransferases after long-term (4 or 5 years) treatment with adefovir dipivoxyl (ADV). All patients were followed for 5.5 years; follow-up visits included measurements of serum alanine aminotransferase (ALT), hepatitis B surface antigen (HBsAg), and HBV DNA monthly, for the first 6 months and every 3-6 months thereafter. Various factors were measured at baseline, the end of treatment (EOT), and following treatment to identify those associated with clearance of HBsAg.
RESULTS: During the first few months of the post-discontinuation period, all patients experienced virologic and 25 (76%) had biochemical relapse. During follow-up period, 18 patients (55%) who had discontinued antiviral therapy achieved sustained response (SR, HBV DNA <2000 IU/L, persistently normal level of ALT). Among these 13 (72%) cleared HBsAg. Fifteen patients (45%) with virologic and/or biochemical relapse were retreated with oral antiviral agents (11 during the first 18 months and 4 after the third year), without evidence of liver decompensation; only 1 lost HBsAg (6%). Higher pretreatment and EOT levels of ALT, no previous treatment with interferon, and lower level of HBsAg at the EOT were significantly associated with HBsAg clearance, based on multivariate analysis.
CONCLUSIONS: In HBeAg-negative patients with CHB, it is safe and effective to discontinue ADV therapy after 4 or 5 years; 55% of patients have SRs and 39% of the patients lose HBsAg.

StephenW

胃肠病学。 2012年5月31日。 [出处提前打印]
持续的响应和停止长期与阿德福韦治疗慢性乙型肝炎HBeAg阴性患者乙肝表面抗原的损失。
律政司司长，Sevastianos五，hadziyann​​is拉布蒂我，Vassilopoulos研发，Hadziyann​​is大肠杆菌
源

，亨利·杜南医院，国家和Kapodistrian，雅典，希腊雅典大学医学系和肝病肝股在Evgenidion医院，雅典，希腊雅典，国家和Kapodistrian的大学分子生物学实验室。
抽象
背景与目的：

停止B型肝炎e抗原（HBeAg）阴性慢性乙型肝炎（CHB）患者的长期治疗核苷（酸）类似物IDE治疗的生化和病毒学的影响知之甚少。
方法：

我们进行了队列观察研究，经过长期与，阿德福韦dipivoxyl（ADV），（4或5年）的治疗后，33例HBeAg阴性慢性乙型肝炎，血清HBV DNA检测不到，转氨酶正常水平。所有患者随访5.5年的随访，包括测量血清谷丙转氨酶（ALT），乙肝表面抗原（HBsAg），乙型肝炎病毒DNA每月，前6个月，以后每3-6个月。在基线，治疗结束（EOT），以下的治疗，以确定相关的HBsAg清除各种因素进行了测量。
结果：

在最初几个月后停药期间，所有患者都经历病毒学，25（76％），生化复发。在随访期间，18例（55％）曾停止抗病毒治疗取得持续应答（SR，乙肝病毒DNA <2000 IU / L，ALT水平持续正常）。其中13个（72％）的HBsAg清除。病毒学和/或生化复发15例（45％）回落，口服抗病毒药物（11头18个月期间，第三年后4），无肝功能失代偿的证据，只有1赔乙肝表面抗原（6％）。 HBsAg清除多元分析的基础上，更高的预处理和EOT（ALT），没有以往的治疗，用干扰素和乙肝表面抗原的EOT的水平较低的水平显着相关。
结论：

HBeAg阴性慢性乙型肝炎患者中，它是安全有效的停止ADV治疗后4年或5年，55％的患者有SRS和39％的患者失去HBsAg的。

疯一点好

怎么看，好像数字不吻合，不过好像是篇好文章。

咬牙硬挺

国外母婴传播的少，治疗效果好

StephenW

回复 疯一点好 的帖子

我同意。停药后，他们都有病毒突破(virological breakthrough), 就是HBVDNA水平上升。然而，不是所有重新治疗,有些甚至清除乙肝表面抗原。

StephenW

回复 咬牙硬挺 的帖子

值得在中国重复实验，看看是否能得到类似的结果.