在长期核苷类药物治疗慢性乙型肝炎：乙肝表面抗原清除9年

StephenW

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

         Tetsuya Hosaka [email protected] (1)
        Fumitaka Suzuki (1)
        Masahiro Kobayashi (1)
        Yuya Seko (1)
        Yusuke Kawamura (1)
        Hitomi Sezaki (1)
        Norio Akuta (1)
        Yoshiyuki Suzuki (1)
        Satoshi Saitoh (1)
        Yasuji Arase (1)
        Kenji Ikeda (1)
        Mariko Kobayashi (2)
        Hiromitsu Kumada (1)

Author Affiliations

        1. Department of Hepatology, Toranomon Hospital, 2-2 Toranomon, Minato-ku, Tokyo, Japan
        2. Research Institute for Hepatology, Toranomon Hospital, 1-3-1, Kajigaya, Takatsu-ku, Kawasaki, Japan




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.
Journal of Gastroenterology

StephenW

背景

清除乙肝表面抗原（HBsAg）被认为是慢性乙肝治疗的终极目标。一种治疗选项是长期nucleot的IDE模拟（S）（NA）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大三阳。所有分析均分离后的HBeAg +和HBeAg-同伙。 Cox比例风险模型被用来确定哪些因素均与HBsAg清除。
结果

HBsAg清除，观察18例（4.1％）的HBeAg +患者和20例（5.7％）的大三阳患者在基线时，转阴率6.4和6.9％，分别超过9年的研究期间。 HBsAg清除是由几个独立的因素，根据大三阳队列变化的影响。对于HBeAg阳性患者，其中包括以前的干扰素治疗，感染B型肝炎病毒（HBV）基因型，≥0.5日志IU / mL的乙肝表面抗原水平下降，6个月内，在6个月的HBeAg间隙。对于大三阳患者，这些包括感染HBV基因型，在6个月下降，乙肝表面抗原，乙肝表面抗原水平<730 IU / mL的基线。
结论

这项研究表明，直接抗病毒的潜力和宿主免疫反应的需要，实现NA治疗HBsAg清除。病毒基因型的强烈影响NA治疗期间HBsAg清除。
胃肠病学杂志

咬牙硬挺

感谢分享

疯一点好

这篇文章到底什么意思没看懂，难道抗病毒可以使表面抗原转阴是吗？
几天了斯提芬没有动静，只要没有斯提芬的帖子这里就如死水一潭，其他人也应该多一点转些好文章过来嘛，现在的论坛上也不好上，真没意思了。

StephenW

回复 疯一点好 的帖子

这篇文章到底什么意思没看懂，难道抗病毒可以使表面抗原转阴是吗？
这些日本科学家认为,抗病毒表面抗原转阴需要宿主免疫的反应.

过去的几个月里，很少新发现和新发展的新闻, 在实验室也许是不同.