血清HBV RNA和HBeAg安全停用核苷类似物有用的标记?

StephenW

Journal of Gastroenterology
October 2013, Volume 48, Issue 10, pp 1188-1204
Serum HBV RNA and HBeAg are useful markers for the safe discontinuation of nucleotide analogue treatments in chronic hepatitis B patients

    Masataka Tsuge,
    Eisuke Murakami,
    Michio Imamura,
    Hiromi Abe,
    Daiki Miki,
    Nobuhiko Hiraga,
    Shoichi Takahashi,
    Hidenori Ochi,
    C. Nelson Hayes,
    Hiroyuki Ginba,
   
Abstract
Background

Treatment for chronic hepatitis B has improved drastically with the use of nucleot(s)ide analogues (NAs). However, NA therapy typically fails to eliminate Hepatitis B virus (HBV) completely, and it is difficult to discontinue these therapies. We previously demonstrated that NA therapy induced immature viral particles, including HBV RNA in sera of chronic hepatitis B patients. In the study reported here, we analyzed the association between HBV RNA titer and the recurrence rate of hepatitis after discontinuation of NA therapy.
Methods

The study cohort comprised 36 patients who had discontinued NA therapy. Serum HBV DNA or DNA plus RNA levels were measured by real time PCR and statistical analyses were performed using clinical data and HBV markers.
Results

At 24 weeks after discontinuation of NA therapy, HBV DNA rebound was observed in 19 of the 36 patients (52.8 %), and alanine aminotransferase (ALT) rebound was observed in 12 of 36 patients (33.3 %). Multivariate statistical analysis was used to identify factors predictive of HBV DNA rebound. The HBV DNA + RNA titer following 3 months of treatment was significantly associated with HBV DNA rebound [P = 0.043, odds ratio (OR) 9.474, 95 % confidence interval (CI) 1.069–83.957)]. Absence of hepatitis B e antigen (HBeAg) at the end of treatment was significantly associated with ALT rebound (P = 0.003, OR 13.500, 95 % CI 2.473–73.705). In HBeAg-positive patients, the HBV DNA + RNA titer after 3 months of treatment was marginally associated with ALT rebound (P = 0.050, OR 8.032, 95 % CI 0.997–64.683).
Conclusions

Monitoring of serum HBV DNA + RNA levels may be a useful method for predicting re-activation of chronic hepatitis B after discontinuation of NA therapy.
Journal of Gastroenterology Journal of Gastroenterology

    Japanese Society of Gastroenterology

StephenW

使用nucleot （次）类似物（NAS） ，慢性乙型肝炎的治疗得到了很大改善。然而， NA治疗通常不能完全消除乙型肝炎病毒（HBV） ，并且难以停止这些疗法。我们以前表明， NA治疗引起的不成熟的病毒颗粒，包括慢性乙肝患者血清中HBV RNA 。在研究报告中，我们分析了乙肝病毒RNA滴度和NA治疗停药后肝炎的复发率之间的关联。
方法

研究队列包括已终止NA治疗的36例患者。血清HBV DNA或DNA加实时PCR和统计分析使用的临床数据和HBV标志物进行测量RNA水平。
结果

NA治疗停药后24周时， HBV DNA反弹在19个观察的36例患者（52.8％） ，谷丙转氨酶（ ALT ）反弹，观察36例（33.3％） 12 。多元统计分析被用来确定HBV DNA反弹的预测因素。 HBV-DNA + RNA滴度治疗3个月后明显伴有HBV DNA反弹[ P = 0.043 ，比值比（OR ） 9.474 ， 95％可信区间（ CI ） 1.069-83.957 ） ] 。显着相关（P = 0.003 ， OR 13.500 ， 95 ％ CI为2.473-73.705 ） ALT反弹缺乏乙型肝炎e抗原（HBeAg）在治疗结束。 HBeAg阳性患者， 3个月的治疗后， HBV-DNA + RNA滴度轻微，伴有ALT反弹（P = 0.050， OR 8.032 ， 95 ％ CI为0.997-64.683 ） 。
结论

监测血清HBV DNA + RNA水平可能是一个有用的方法预测NA治疗慢性乙型肝炎停药后重新激活。