白人患者HBsAg血清清除后远期疗效

StephenW

Long-term outcome in Caucasian patients with chronic hepatitis B virus infection after HBsAg seroclearance

    Eugenia Lauret1,
    María L. González-Diéguez1,
    Mercedes Rodríguez2,
    Marta González3,
    Santiago Melón2,
    Luis Rodrigo1 and
    Manuel Rodríguez1,*

Article first published online: 24 JAN 2014

DOI: 10.1111/liv.12461

© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

Issue
Liver International

Volume 35, Issue 1, pages 140–147, January 2015

Liver Int. 2015; 35: 140–147
Author Information

    1    Liver Unit, Division of Gastroenterology and Hepatology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
    2    Virology Unit, Department of Microbiology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
    3    Department of Pathology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain

* Correspondence
Dr. Manuel Rodríguez, MD, Liver Unit, Division of Gastroenterology and Hepatology, Hospital Universitario Central de Asturias, Celestino Villamil s/n, Oviedo, Asturias 33006, Spain
Tel/Fax: + 34 985 273614
e-mail: [email protected]
Publication History

    Issue published online: 12 JAN 2015
    Article first published online: 24 JAN 2014
    Accepted manuscript online: 2 JAN 2014 12:52PM EST
    Manuscript Accepted: 28 DEC 2013
    Manuscript Received: 9 JUL 2013

Abstract
Background & Aims

The natural course after hepatitis B surface antigen (HBsAg) seroclearance in Caucasian patients with chronic hepatitis B virus (HBV) infection is not well-defined. To investigate the clinical characteristics and outcome in a series of European Caucasian patients with chronic HBV infection according to HBsAg response over time.
Methods

A total of 612 patients with compensated chronic HBV infection and without other cause of liver disease were prospectively followed up. Seventy-eight subjects cleared HBsAg and 534 remained HBsAg-positive. Clinical and virological examinations were periodically performed and development of cirrhosis and liver-related complications was monitored during a mean follow-up time of 9.9 years.
Results

After HBsAg seroclearance, serum HBV DNA was undetectable in 38 patients in whom it was tested and HBsAg reappearance was observed in two subjects (2.6%). At 15 years of follow-up, the cumulative probability of developing a liver-related complication was 11.6% in HBsAg-positive patients and 1.8% in those with HBsAg loss (P = 0.03), although this benefit was limited to patients with cirrhosis (P < 0.001) and to those who received therapy (P < 0.01). Among patients without cirrhosis and among those who did not receive therapy, the probability was not different between those who cleared the HBsAg and those who did not (P = 0.3 and P = 0.5 respectively).
Conclusion

Hepatitis B surface antigen loss confers a significant clinical benefit in Caucasian subjects with HBV-related cirrhosis and in those with chronic HBV infection who receive antiviral therapy. However, HBsAg reappearance can be observed in selected cases.

StephenW

在白人患者的慢性乙肝病毒感染的HBsAg血清清除后远期疗效

    尼娅Lauret1，
    玛丽亚L.冈萨雷斯，Diéguez1，
    奔驰Rodríguez2，
    玛塔González3，
    圣地亚哥Melón2，
    路易斯Rodrigo1和
    曼努埃尔Rodríguez1，*

文章首次在网上公布：2014年1月24日

DOI：10.1111/ liv.12461

©2014年约翰·威利父子A / S。发布时间由John Wiley＆Sons出版有限公司

问题
肝国际

第35卷，第1期，页140-147，2015年1月

肝诠释。 2015年; 35：140-147
作者信息

    1肝单位，胃肠病学和肝病，医院宇宙报中央阿斯图里亚斯，奥维多，阿斯图里亚斯，西班牙分部
    2病毒组，微生物学系，医院宇宙报中央阿斯图里亚斯，奥维多，阿斯图里亚斯，西班牙
    病理，医院宇宙报中央阿斯图里亚斯，奥维多，阿斯图里亚斯，西班牙3系

*通讯
曼努埃尔·罗德里格斯，MD博士，肝单位，胃肠病学和肝病，医院宇宙报中央阿斯图里亚斯，塞莱斯蒂诺普维多维拉米S / N，奥维耶多，阿斯图里亚斯33006，西班牙分部
电话/传真：+34985273614
电子邮件：[email protected]
出版史

    发行网上公布：2015年1月12日
    文章首次在网上公布：2014年1月24日
    接受稿件在线：2014年1月2日下午12时52分EST
    稿件接受：2013年12月28日
    稿件收稿日期：2013年7月9日

抽象
背景与目的

乙型肝炎表面抗原（HBsAg）血清清除在高加索人慢性乙型肝炎病毒（HBV）感染后的自然过程不明确定义的。根据乙肝表面抗原的反应随着时间的推移调查了一系列的欧洲白人患者的慢性HBV感染者的临床特征和结果。
方法：

总共有612例代偿慢性HBV感染和无肝病等原因进行前瞻性随访。七八个科目清除HBsAg和534保持HBsAg阳性。临床和病毒学检查均定期进行肝硬化的发展和肝脏相关的并发症是在9.9岁，平均随访时间监控。
结果

乙肝表面抗原血清学清除后，血清HBV DNA检测不到的38例患者中谁也进行了测试与HBsAg再现观察二级学科（2.6％）。在15年的随访，开发肝脏相关并发症的累积概率为11.6％，在HBsAg阳性患者和那些与HBsAg消失（P=0.03）1.8％，尽管这样做的好处是有限的肝硬化患者（ P <0.001）和那些谁接受治疗（P <0.01）。其中患者无肝硬化和在那些谁没有接受治疗的概率是不是那些谁清除HBsAg和那些谁没有（P =0.3和P =0.5，分别）之间的不同。
结论

乙肝表面抗原的损失赋予高加索科目与HBV相关的肝硬化和患有慢性HBV感染者谁接受抗病毒治疗的显著的临床益处。然而，乙肝表面抗原再现可以选择的情况下，可以观察到。