乙肝表面抗原定量预测HBsAg转阴和HBV复发拉米夫定停药后作用

StephenW

Journal of Hepatology

Volume 61, Issue 3, September 2014, Pages 515–522

The role of hepatitis B surface antigen quantification in predicting HBsAg loss and HBV relapse after discontinuation of lamivudine treatment

    Chien-Hung Chen,
    Sheng-Nan Lu,
    Chao-Hung Hung,
    Jing-Houng Wang,
    Tsung-Hui Hu,
    Chi-Sin Changchien,
    Chuan-Mo Lee,

        DOI: 10.1016/j.jhep.2014.04.029

Background & Aims

We investigated whether the quantification of hepatitis surface antigen (HBsAg) could predict HBsAg loss or hepatitis B virus (HBV) relapse after stopping lamivudine treatment.
Methods

A total of 188 naive chronic hepatitis B patients (83 HBeAg-positive, 105 HBeAg-negative patients), who were previously treated with lamivudine (treatment duration: 89.3 ± 35.9 weeks, range: 52–243 weeks) but stopped the treatment for at least 12 months were recruited.
Results

The cumulative incidence of HBsAg loss and HBV relapse at year 6 after stopping lamivudine treatment was 24% and 65.9% respectively. Cox regression analysis revealed that lower alanine aminotransferase (ALT) at baseline, lower HBsAg levels at the end of treatment, and longer treatment duration were independent predictors for HBsAg loss, and old age, male sex and higher HBsAg levels at the end of treatment were independent predictors for post-treatment HBV relapse. At the end of treatment, the HBsAg cut-off value of 300 IU/ml could predict 55.6% (5/9) HBsAg loss in HBeAg-positive patients. In HBeAg-negative patients, the HBsAg cut-off values of 120 and 200 IU/ml could predict 79.2% (19/24) HBsAg loss and 93.3% (28/30) post-treatment sustained response respectively. Further HBsAg reduction (>0.22 log IU/ml) at month 6 after stopping treatment was an independent predictor for HBsAg loss after adjusting for HBsAg level at the end of treatment.
Conclusions

Serum HBsAg level at the end of treatment is a useful predictor to guide the timing of stopping lamivudine treatment in chronic hepatitis B patients.


    Corresponding author. Address: Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Ta Pei Road, Kaohsiung, Taiwan. Tel.: +886 7 7317123; fax: +886 7 7318762.

StephenW

中华肝脏病杂志

61卷，第3期，2014年9月，页515-522

乙肝表面抗原定量预测HBsAg转阴和HBV复发拉米夫定停药后作用

    陈建宏，
    卢胜男，
    朝鸿鸿，
    王景弘，
    崇回沪，
    智仙Changchien，
    川钼李

        DOI：10.1016/ j.jhep.2014.04.029

背景与目的

我们研究了肝炎表面抗原（HBsAg）的量化可否停止拉米夫定治疗后预测HBsAg消失或乙型肝炎病毒（HBV）复发。
方法

共有188天真的慢性乙型肝炎患者（83例HBeAg阳性，105例HBeAg阴性患者），谁以前用拉米夫定（治疗时间：89.3±35.9周，范围：52-243周）治疗，但停止治疗的至少12个月被招募。
结果

HBsAg消失和HBV复发的6年停止拉米夫定治疗后的累计发生率分别为24％和65.9％。 Cox回归分析显示，降低谷丙转氨酶（ALT）在基线，降低HBsAg水平在治疗结束后，和更长的治疗时间分别为HBsAg消失的独立预测因子，与老年，男性和更高的HBsAg水平在治疗结束时分别为独立预测因子治疗后乙肝复发。在治疗结束后，300国际单位的乙肝表面抗原临界值/毫升可预测55.6％（5月9日），HBsAg消失在HBeAg阳性患者。在HBeAg阴性患者中，乙肝表面抗原截止的120和200国际单位值/毫升可预测79.2％（19/24）HBsAg消失和93.3％（28/30），治疗后分别为持续响应。在治疗结束调整的HBsAg水平后停止治疗的独立预测HBsAg消失后，进一步降低乙肝表面抗原（>0.22登录国际单位/毫升），在6个月。
结论

血清HBsAg水平在治疗结束是一个有用的预测，指导慢性乙肝患者停药拉米夫定治疗的时机。


    通讯作者。地址：肝，消化内科，内科，高雄长庚医院，123大陂路，高雄，台湾分部。电话：+88677317123;传真：+88677318762。

styxl

好多文章消失了耶

StephenW

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