低龄和女性的性预测HBeAg阳性慢性乙型肝炎患者有较好的治疗

StephenW

Younger age and female sex predict a better therapeutic response in HBeAg-positive chronic hepatitis B patients to entecavir therapy
Wei-Chih Su
Tsung-Cheng Hsieh
Tsai-Yuan Hsieh
Kuo-Chih Tseng
Cheng-Yuan Peng
Chih-Lin Lin
Tung-Hung Su
Tsung-Hsien Hsiao
Tai-Chung Tseng
Hans Hsienhong Lin
Chia-Chi Wang
Jia-Horng Kao

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Advances in Digestive Medicine 01/2014;

ABSTRACT Background
Clinical trials and real-world data confirm the efficacy of entecavir treatment for chronic hepatitis B (CHB); however, the factors associated with a favorable response remain unknown.

Methods
In a retrospective multicenter study, 132 treatment-naïve hepatitis B e antigen (HBeAg)-positive CHB patients (71% male; median age, 40.2 years) received entecavir therapy for >2 years. At baseline, 15% of these patients had cirrhosis. The primary endpoint was HBeAg loss at 2 years of entecavir treatment.

Results
The rates of serum alanine aminotransferase (ALT) normalization at treatment Year 1 and Year 2 were 86% and 88%, respectively. The cumulative rate of HBeAg loss at treatment Year 1 and Year 2 were 17% and 33.3%, respectively. The rates of undetectable levels of serum hepatitis B virus (HBV) deoxyribonucleic acid (DNA) at treatment Year 1 and Year 2 were 64% and 80.8%, respectively. In univariate analysis, HBeAg loss at 2 years was associated with a young age (≤35 years; p = 0.007) and a high baseline ALT level (p < 0.001). Multivariate analysis after adjusting for age, sex, and ALT level [>5 times the upper limit of normal (ULN)] showed that a young age (odds ratio, 2.66; 95% confidence interval, 1.2–5.92) and male sex (odds ratio, 0.36; 95% confidence interval, 0.16–0.83) were independent factors associated with HBeAg loss at 2 years of therapy.

Conclusion
Two-year entecavir therapy has good biochemical and virologic responses; however, the rate of HBeAg loss is modest in HBeAg-positive CHB patients. A young age (i.e., ≤35 years) and female sex were also associated with a better serologic response.

StephenW

低龄和女性的性预测HBeAg阳性慢性乙型肝炎患者有较好的治疗反应恩替卡韦治疗
威志苏
宗锦城
蔡渊谢
国治曾
彭成元
芝林霖
东红素
宗贤孝
大涌曾
汉斯Hsienhong林
王嘉齐
嘉宏高

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进展消化内科01/2014;

摘要背景
临床试验和真实世界的数据证实对慢性乙型肝炎恩替卡韦治疗（CHB）的疗效;然而，在一个良好的响应相关的因素，仍然是未知的。

方法
在一项回顾性的多中心研究，132治疗初治乙肝e抗原（HBeAg）阳性的慢性乙肝患者（71％为男性，平均年龄40.2岁）接受恩替卡韦治疗>2年。在基线水平，这些患者中15％有肝硬化。主要终点是HBeAg消失2年恩替卡韦治疗。

结果
血清丙氨酸转氨酶（ALT）正常化的治疗1年和第2年的比率分别为86％和88％。 HBeAg消失在治疗第1年和第2年的累积率分别为17％和33.3％。血清乙型肝炎病毒（HBV）脱氧核糖核酸（DNA）检测不到的水平在治疗第1年和第2年的比率分别为64％和80.8％。在单因素分析中，HBeAg消失2年是一个年轻的年龄（≤35岁，P=0.007）和高基线ALT水平（P <0.001）。在调整了年龄，性别和ALT水平[>标准上限（ULN）的5倍，上限]经过多因素分析显示，年纪轻轻（比值比为2.66; 95％置信区间，1.2-5.92）和男性（胜算比，0.36; 95％可信区间，0.16-0.83）分别与HBeAg消失2年的治疗相关的独立因素。

结论
为期两年的恩替卡韦治疗具有良好的生物化学和病毒学反应;然而，HBeAg阴转率是适度的HBeAg阳性CHB患者。年轻的时候（即≤35岁），女性也有更好的血清学应答有关。