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本帖最后由 StephenW 于 2014-10-23 11:18 编辑
1881Increased HBsAg Decline in Sustained Responders After Discontinuation of Long-term Nucleos(t)ide Analogue Therapy in Chronic Hepatitis BHeng Chi1, Bettina E. Hansen1, Mahmoud Abu-Amara2, Colina Yim2, Pauline Arends1, Jordan J. Feld2, Annemiek A. van der Eijk3, Robert J. de Knegt1, David K. Wong2, Harry L. Janssen1,2;1Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands; 2Toronto Centre for Liver Disease, Toronto Western & General Hospital, University of Toronto, Toronto, ON, Canada; 3Viroscience, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
BACKGROUND: Serum HBsAg levels can be used as a surrogate marker for the interaction between the immune system and the hepatitis B virus. We aimed to study the kinetics of HBsAg levels in chronic hepatitis B (CHB) patients who discontinued nucleos(t)ide analogue (NA) therapy.
METHODS: We included 94 consecutive patients who stopped NA after at least one year of therapy. Patients could be HBeAg-positive or HBeAg-negative at start-of-therapy, but all were HBeAg-negative and had undetectable HBV DNA at time of discontinuation. Relapse was defined as HBV DNA >2,000 IU/mL measured twice 6 months apart within one year, or retreatment after an initial HBV DNA increase.
RESULTS: In total, HBsAg decline could be calculated for 69 patients, of whom 26 were relapsers. The on-treatment HBsAg decline was comparable between relapsers and sustained responders, whereas the post-treatment HBsAg decline was greater in sustained responders compared to relapsers (Figure). After adjustment for start-of-therapy HBeAg-status, cirrhosis, and consolidation therapy duration, post-treatment HBsAg decline remained significantly associated with absence of relapse (p=0.014). Forty-seven patients had paired on-treatment and post-treatment HBsAg decline data available. Within this group, HBsAg decline increased in sustained responders from −0.09 to −0.17 log IU/mL per year (p=0.009) after NA therapy cessation, but not in relapsers (−0.03 vs. −0.07 log IU/ mL per year; p=0.85).
CONCLUSIONS: After stopping long-term NA therapy in CHB patients, HBsAg decline increased in sustained responders, whereas these levels remained at the same level in relapsers. These results suggest the potential of host-induced immune control and viral clearance in sustained responders after NA therapy cessation.
Disclosures:
Colina Yim - Advisory Committees or Review Panels: Merck Canada, Gilead, Janssen
Jordan J. Feld - Advisory Committees or Review Panels: Idenix, Merck, Janssen, Gilead, AbbVie, Merck, Theravance, Bristol Meiers Squibb; Grant/Research Support: AbbVie, Boehringer Ingelheim, Janssen, Gilead, Merck
Robert J. de Knegt - Advisory Committees or Review Panels: MSD, Roche, Norgine, Janssen Cilag; Grant/Research Support: Gilead, MSD, Roche, Janssen Cilag, BMS; Speaking and Teaching: Gilead, MSD, Roche, Janssen Cilag
David K. Wong - Grant/Research Support: Gilead, BMS, Vertex, BI
Harry L. Janssen - Consulting: Abbott, Bristol Myers Squibb, Debio, Gilead Sciences, Merck, Medtronic, Novartis, Roche, Santaris; Grant/Research Support: Anadys, Bristol Myers Squibb, Gilead Sciences, Innogenetics, Kirin, Merck, Medtronic, Novartis, Roche, Santaris
The following people have nothing to disclose: Heng Chi, Bettina E. Hansen, Mahmoud Abu-Amara, Pauline Arends, Annemiek A. van der Eijk
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发表于 2014-10-23 11:18
