AASLD2014:跌幅定量血清HBsAg水平在巩固治疗之后HBeAg消失在治疗

StephenW

1875
Decline in Quantitative Serum HBsAg Level during Consolidation Therapy Following HBeAg Loss in HBeAg-positive Chronic Hepatitis B Patients Treated with Entecavir
Wen-Pang Su, Cheng-Yuan Peng, Hsueh-Chou Lai, Chia-Hsin Lin, Po-Heng Chuang, Sheng-Hung Chen;
China Medical University Hospital, Taichung, Taiwan

Background: The decline in quantitative serum hepatitis B surface antigen (qHBsAg) level during consolidation therapy following HBeAg loss or seroconversion in HBeAg-positive chronic hepatitis B (CHB) patients undergoing long-term entecavir (ETV) therapy remains unclear.
Patients and Methods: One hundred and seventy four treatment-naive HBeAg-positive CHB patients had been treated with ETV for at least 1 year. Serum HBsAg was measured with the Abbott Architect HBsAg QT assay. The qHBsAg levels were determined at baseline, at the time of HBeAg loss and/or seroconversion, and then annually after HBeAg loss. Additional therapy following HBeAg loss was defined as consolidation therapy in the current study.
Results: During the mean treatment duration of 51 ±21 months, 90 out of 174 patients (51.7%) achieved HBeAg loss and 51 patients (29.3%) achieved HBeAg seroconversion. Twenty-six patients achieved HBeAg loss and seroconversion concurrently and 25 patients achieved HBeAg seroconversion with a median interval of 3.0±11.5 (0.75-47) months following HBeAg loss. The mean treatment duration and the mean time to HBeAg loss for the 90 patients was 51.2±19.4 and 25.1 ±20.1 months, respectively. Seventy three (81.1%), 27 (30%), 12 (13.3%), 7 (7.9%), and 4 (4.4%) patients had received 1, 2, 3, 4, and 5 years of consolidation therapy following HBeAg loss, respectively. The median qHBsAg decline from HBeAg loss to HBeAg seroconversion in the 25 patients was 0.0±0.06 log10 IU/ mL. Among 73 patients with at least one year of consolidation therapy, the median decline in qHBsAg levels from baseline to HBeAg loss, and from HBeAg loss to one year after HBeAg loss were 0.36±0.80 (P<0.0001) and 0.00±0.23 (P=0.7304) log10 IU/mL, respectively. Among 27 patients with at least two years of consolidation therapy, the median decline in qHB-sAg levels from baseline to HBeAg loss, from HBeAg loss to one year after HBeAg loss, and from one year to two years after HBeAg loss were 0.27±0.57 (P=0.0017), 0.04±0.37 (P=0.9896), and 0.10±0.26 log10 IU/mL (P=0.009), respectively. Among 12 patients with at least three years of consolidation therapy, the median decline in qHBsAg levels from baseline to HBeAg loss, from HBeAg loss to one year after HBeAg loss, from one year to two years, and from two years to three years after HBeAg loss were 0.41 ±0.49 (P=0.0244), 0.01 ±0.44 (P=0.9697), 0.10±0.31 (P=0.0273), and 0.08±0.21 log10 IU/mL (P=0.0137), respectively.
Conclusion: Long-term ETV therapy is associated with a significant qHBsAg decline from baseline to HBeAg loss, and during the second and third, but not the first year of consolidation therapy following HBeAg loss in HBeAg-positive CHB patients.

Disclosures:

The following people have nothing to disclose: Wen-Pang Su, Cheng-Yuan Peng, Hsueh-Chou Lai, Chia-Hsin Lin, Po-Heng Chuang, Sheng-Hung Chen
1876

StephenW

1875
跌幅定量血清HBsAg水平在巩固治疗之后HBeAg消失在治疗恩替卡韦HBeAg阳性慢性乙型肝炎患者
文庞僳，彭成元，薛岳，周黎，张嘉心莲，宝衡庄，胜洪辰;
中国医药大学附设医院，台中，台湾

背景：巩固治疗期间，下列HBeAg转阴或血清学转换的HBeAg阳性慢性乙型肝炎（CHB）患者进行长期的恩替卡韦（ETV）治疗的定量血清乙肝表面抗原（qHBsAg）水平的下降仍不清楚。
病人与方法：10674治疗初治的HBeAg阳性CHB患者经治疗后已与恩替卡韦，至少1年。血清HBsAg测定雅培建筑师的HBsAg QT间期检测。该qHBsAg水平基线每年HBeAg消失后确定，在HBeAg消失和/或血清学转换的时间，然后。以下HBeAg阴转其他疗法定义为巩固治疗，在目前的研究中。
结果：在51±21月，90出174例（51.7％），平均治疗时间达到HBeAg消失和51例（29.3％）获得HBeAg血清学转换。 26例获得HBeAg消失和血清学转换的同时和25例患者达到HBeAg血清学转换为3.0±11.5（0.75-47）个月后HBeAg转阴的中位区间。平均治疗时间和平均时间HBeAg消失的90例患者为51.2±19.4和25.1±20.1个月分别。七十三名（81.1％），27（30％），12（13.3％），7（7.9％），4例（4.4％）患者接受了1，2，3，4，和下面的HBeAg5年巩固治疗损失分别。从HBeAg转阴到HBeAg血清转换在25例患者中位qHBsAg跌幅为0.0±0.06日志10国际单位/毫升。其中73例有至少一年的巩固治疗，平均跌幅qHBsAg水平从基线到HBeAg消失，并从HBeAg消失一年后HBeAg转阴分别为0.36±0.80（P <0.0001）和0.00±0.23（P = 0.7304）日志10国际单位/毫升，分别。其中27例有至少两年的巩固治疗，平均跌幅QHB下垂水平从基线到HBeAg消失，从HBeAg消失一年HBeAg消失后，并从一年到两年的HBeAg转阴后0.27±0.57 （P =0.0017），0.04±0.37（P =0.9896），和0.10±0.26日志10国际单位/毫升（P = 0.009），分别。 12例患者中有至少三年的巩固治疗，平均跌幅qHBsAg水平从基线到HBeAg消失，从HBeAg消失一年HBeAg消失后，从一年到两年，并从两年大三阳三年后亏损分别为0.41±0.49（P =0.0244），0.01±0.44（P =0.9697），0.10±0.31（P =0.0273）和0.08±0.21日志10国际单位/毫升（P =0.0137），分别为。
结论：长期恩替卡韦治疗可显著qHBsAg下降，从基线HBeAg消失有关，并在巩固治疗的第二和第三，而不是第一年以下HBeAg消失在HBeAg阳性CHB患者。

披露：

下面的人都没有透露：文庞夙，彭成元，薛岳，周黎，张嘉心莲，宝衡庄，胜洪辰