清除表面抗原长期核苷类似物治疗慢性乙肝：从9年的纵

StephenW

http://www.ncbi.nlm.nih.gov/pubmed/23065021
清除表面抗原长期核苷类似物治疗慢性乙型肝炎：从9年的纵向研究的结果。
J Gastroenterol. 2012 Oct 12. [Epub ahead of print]
Clearance of hepatitis B surface antigen during long-term nucleot(s)ide analog treatment in chronic hepatitis B: results from a nine-year longitudinal study.
Hosaka T, Suzuki F, Kobayashi M, Seko Y, Kawamura Y, Sezaki H, Akuta N, Suzuki Y, Saitoh S, Arase Y, Ikeda K, Kobayashi M, Kumada H.
Source

Department of Hepatology, Toranomon Hospital, 2-2 Toranomon, Minato-ku, Tokyo, Japan, [email protected].
Abstract
BACKGROUND:

Clearance of hepatitis B surface antigen (HBsAg) is considered the ultimate goal in chronic hepatitis B treatment. One treatment option is long-term nucleot(s)ide analog (NA) therapy. We followed a group of long-term NA therapy patients to evaluate the efficacy of this treatment in promoting clearance and longitudinal declines of HBsAg.
METHOD:

The study included 791 NA therapy patients who received lamivudine as their first drug. At the baseline, 442 patients were hepatitis B e antigen (HBeAg)+ and 349 were HBeAg-. All analyses were performed after separating the HBeAg+ and HBeAg- cohorts. Cox proportional hazards models were used to determine which factors were associated with HBsAg clearance.
RESULTS:

HBsAg clearance was observed in 18 (4.1 %) of the HBeAg+ patients and 20 (5.7 %) of the HBeAg- patients at baseline, giving seroclearance rates of 6.4 and 6.9 %, respectively, over the nine-year study period. HBsAg clearance was influenced by several independent factors that varied according to HBeAg cohort. For HBeAg+ patients, these included previous interferon therapy, infection with hepatitis B virus (HBV) genotype A, a ≥0.5 log IU/mL decline in HBsAg level within six months, and clearance of HBeAg at six months. For HBeAg- patients, these included infection with HBV genotype A, decline in HBsAg at six months, and a baseline HBsAg level of <730 IU/mL.
CONCLUSION:

This study suggests that both direct antiviral potential and host immune response are needed to achieve HBsAg clearance by NA therapy. Viral genotype strongly influenced HBsAg clearance during NA therapy.

StephenW

背景：

B型肝炎表面抗原（HBsAg）的间隙被认为是慢性乙肝治疗的最终目标。一个治疗方法是长期核苷类似物治疗。我们跟着一群长期NA治疗的患者，以评估这种治疗方法的疗效，促进通关和纵向的HBsAg下降。
方法：

这项研究包括791 NA治疗的患者接受拉米夫定作为他们的第一个药物。在基线，442例乙肝e抗原（HBeAg）+和349为HBeAg。所有的分析进行了分离后的HBeAg +和HBeAg同伙的。 Cox比例风险模型，以确定哪些因素与HBsAg清除。
结果：

HBsAg清除，观察18例HBeAg +患者和20例（5.7％），e抗原患者在基线（4.1％），6.4和6.9％，分别超过9年的研究期间给转阴率。 HBsAg清除是由几个独立的因素，根据HBeAg的队列变化的影响。对于HBeAg（+）患者，其中包括以前的干扰素治疗，感染B型肝炎病毒（HBV）基因型A，A≥0.5日志IU / mL的六个月内，HBsAg水平下降，和e抗原在6个月的清除。对于HBeAg患者，其中包括感染HBV基因型A，乙肝表面抗原在6个月的下降，和基线HBsAg水平<730 IU /毫升。
结论：

这项研究表明，直接抗病毒的潜力和宿主的免疫反应所需要的实现HBsAg清除NA治疗。病毒基因型的强烈影响NA治疗期间HBsAg清除。

StephenW

一个非常令人失望的结果。

9病成医

英文看不懂,汉语也看不明白.

咬牙硬挺

基因到底有何影响呢

StephenW

回复 9病成医 的帖子

9年期间,核苷类似物治疗, 只有约6％清除HBsAg.

StephenW

回复 咬牙硬挺 的帖子

一般情况下，A基因型有良好的干扰素治疗反应.

sddp1

摘要：
目前抗乙肝和丁肝感染治疗手段有限且不能治愈，需要发展新的干扰病毒复制的其他过程