治疗停止在非肝硬化，e抗原阴性的慢性乙肝是安全和有效的

StephenW

Source: Aliment Pharmacol Ther  |  Posted 1 day ago
Treatment cessation in noncirrhotic, e-antigen negative chronic hepatitis B is safe and effective following prolonged anti-viral suppression with nucleosides/nucleotides; Patwardhan V, Sengupta N, Bonder A, Lau D, Afdhal N; Alimentary Pharmacology & Therapeutics (Aug 2014)

   
BACKGROUND The treatment of HBeAg-negative chronic hepatitis B (CHB) is considered to be open-ended, with no guidelines for treatment cessation.

AIM To evaluate biochemical and virological relapse requiring retreatment in noncirrhotic HBeAg-negative CHB in patients who stopped treatment following a period of prolonged viral suppression with nucleotides/nucleosides.

METHODS We performed a single-centre retrospective chart review of patients with HBeAg-negative CHB who maintained viral suppression for 4-5 years on anti-viral treatment, and thus subsequently stopped treatment. The primary end point of composite relapse was defined by an increase in HBV DNA>2000 IU/mL, ALT elevation above 1.25 ×  normal or doubling of ALT from cessation, and re-initiation of anti-viral therapy.

RESULTS We identified 33 patients with HBeAg-negative CHB who stopped treatment following viral suppression. Mean treatment duration was 5.28 ± 2.73 years. Patients were treated with lamivudine (3), adefovir (14), entecavir (4), and tenofovir (12). Eleven (33%) patients met the primary end point of composite relapse. For individual end points, 21 (63%) patients had a viral relapse, 16 (48%) had a biochemical relapse, and 16 (48%) restarted treatment, leaving 17 (52%) patients who remained treatment-free over a median 36 months of follow-up. Lower pre-treatment ALT and detectable HBV DNA within the first month after treatment discontinuation were associated with increased rates of composite relapse (HR 1.01; P = 0.022 for ALT and HR 1.01; P = 0.038 for HBV DNA).

CONCLUSION Patients with noncirrhotic HBeAg-negative CHB can stop treatment after greater than 4-5 years of suppressive therapy with nucleosides/nucleotides with more than 50% remaining treatment-free.

StephenW

资料来源：滋养品药理有|发布时间1天前
治疗停止在非肝硬化，e抗原阴性的慢性乙肝是安全和有效的在长期的抗病毒抑制核苷/核苷酸; Patwardhan五，森古普塔N，固晶机A，刘D，Afdhal N;消化系统药理学与治疗学（2014年8月）

   
背景HBeAg阴性慢性乙型肝炎（CHB）的治疗被认为是开放式的，与治疗戒烟没有指引。

旨在评价生化和病毒学复发再治疗需要在肝硬化的HBeAg阴性慢性乙型肝炎谁在经过一段时间的长期抑制病毒与核苷酸/核苷停止治疗的病人。

方法我们进行了例HBeAg阴性CHB谁保持病毒抑制4-5年抗病毒治疗，因而随后停止治疗单中心回顾性分析。复合复发的主要终点是通过增加HBV DNA>2000 IU/ mL时，ALT升高高于1.25×正常或停止加倍ALT键，并重新开始抗病毒治疗中定义。

结果，我们确定了谁下的病毒抑制停止治疗HBeAg阴性慢性乙型肝炎33例。平均处理时间为5.28±2.73年。患者均采用拉米夫定（3），阿德福韦（14），恩替卡韦（4）和替诺福韦（12）。十（33％）患者达到复合复发的主要终点。对于个别终点，21（63％）患者进行了病毒复发，16（48％），有生化复发，和16（48％）重新开始治疗，留下17（52％）患者谁仍然无治疗过的中位数36个月的随访。较低的前处理ALT和检测HBV-DNA的第一个月内停药后均与复合复发率增加（HR =1.01，P=0.022 ALT和HR1.01，P=0.038 HBV DNA阳性）。

结论患者肝硬化的HBeAg阴性慢性乙型肝炎后可大于4-5年抑制治疗核苷/核苷酸具有50％以上的剩余无治疗的停止治疗。