长期的核苷（酸）类似物IDE治疗的患者与乙肝e抗原阴性乙肝

StephenW

Systematic review: cessation of long-term nucleos(t)ide analogue therapy in patients with hepatitis B e antigen-negative chronic hepatitis B
长期的核苷（酸）类似物IDE治疗的患者与乙肝e抗原阴性乙肝停药
    M.-L. Chang1, Y.-F. Liaw1,* andS. J. Hadziyannis2

    1    Liver Research Unit, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan
    2    Second Department of Medicine at Hippokration Hospital, National and Kapodistrian University of Athens, Athens, Greece

* Correspondence to:
Prof. Y.-F. Liaw, Liver Research Unit, Chang Gung Memorial Hospital, 199, Tung Hwa North Road, Taipei, 105, Taiwan.
E-mail: [email protected]

Article first published online: 10 JUN 2015

DOI: 10.1111/apt.13272

© 2015 John Wiley & Sons Ltd

Issue
Vol. 42 Issue 1
Alimentary Pharmacology & Therapeutics

Early View (Online Version of Record published before inclusion in an issue)
Article has an altmetric score of 1


Summary
Background

It has been debated whether finite nucleos(t)ide analogue therapy is feasible in HBeAg-negative chronic hepatitis B.
Aim

To review this issue systematically.
Methods

Using text terms HBsAg and various nucleos(t)ide analogues, PubMed was searched between 1995 and 2014 to find studies on therapy >6 months in adult HBeAg-negative chronic hepatitis B patients with off-therapy follow-up >6 months.

Results

Twenty-two studies with a total of 1732 patients were identified and included. The median duration of therapy, consolidation therapy and off-therapy follow-up ranged from 6 months to 8 years, 4 to 96 weeks and 6 to 80 months respectively. Patients were monitored with serum ALT and HBV DNA monthly in the first 1–3 months and every 3–6 months afterwards in most studies. The 1-year off-therapy ‘virological relapse’ (HBV DNA >2000 IU/mL) and ‘clinical relapse’ (HBV DNA > 2000 IU/mL + ALT elevation) occurred in <70% and <50% of the patients, respectively, and <40% of the patients received re-treatment. These rates were higher in patients with shorter treatment, shorter consolidation therapy and those treated with less potent nucleos(t)ide analogues. Off-therapy severe flares were rare and hepatic decompensation was reported in only one patient with cirrhosis. Biochemical relapse reflecting enhanced immune-mediated hepatocyte killing may lead to a higher chance for off-therapy HBsAg seroclearance and be possibly desirable.

Conclusions

With an appropriate stopping rule and a proper off-therapy monitoring plan, cessation of long-term nucleos(t)ide analogue therapy prior to HBsAg seroclearance in HBeAg-negative chronic hepatitis B is a feasible alternative to indefinite treatment.

StephenW

系统评价：长期的核苷（酸）类似物IDE治疗的患者与乙肝e抗原阴性的慢性乙肝停止用药

    M.-L.畅，Y.-F. Liaw1，*和S。 J. Hadziyann​​is2

    1肝脏研究单位，长庚医院，医学长庚大学，台湾台北
    医学2二系Hippokration医院，国家和雅典Kapodistrian大学，雅典，希腊

*通讯作者：
Y.-F.教授廖，肝脏研究单位，长庚医院，199，华通北路，台北105，台湾。
电子信箱：[email protected]

文章首次在线发表：2015年6月10日

DOI：10.1111 / apt.13272

2015年©约翰·威利父子有限公司

问题
卷。 42第1期
消化系统药理学和治疗

早期查看（包含之前记录的在线版本出版中的问题）
文章有altmetric比分1


总结
背景

它一直争论不休有限核苷（酸）类似物IDE治疗是否可行HBeAg阴性慢性乙型肝炎
目的

为了系统地审查这一问题。
方法

使用文本条款HBsAg和各种核苷（酸）类似物，考研被搜查1995年和2014年间，以找到治疗> 6个月的研究在成年HBeAg阴性慢性乙型肝炎患者的脱离治疗随访> 6个月。

结果

二十二个，共1732患者的研究进行鉴定和包括在内。的治疗，巩固治疗和非治疗随访的中位数持续时间6个月分别介于到8年，4至96周和6至80个月。患者血清ALT和HBV DNA在每月的第一个1-3个月，每3-6个月之后，在大多数的研究监测。 1年离疗法“病毒学复发'（HBV DNA> 2000 IU / mL）和”临床复发“（HBV DNA> 2000 IU /毫升+ ALT升高）发生在<70％和患者<50％，分别与<的40％的患者接受再治疗。这些比率的患者有较高的治疗更短，更短的巩固治疗和那些不太有效的核苷（酸）类似物治疗。场外治疗重症耀斑罕见，肝功能失代偿报道，在只有一个肝硬化病人。生化复发反映增强免疫介导的肝细胞杀伤可能导致对场外治疗乙肝表面抗原血清学清除的机会较高，并可能可取的。

结论

用适当的停止规则和适当的场外治疗监测计划，长期核苷（酸）类似物IDE之前疗法对HBsAg血清清除HBeAg阴性慢性乙型肝炎停止用药是一种可行的替代治疗不定。

StephenW

全文:

http://onlinelibrary.wiley.com/doi/10.1111/apt.13272/pdf

9病成医

哪位高人辛苦辛苦，帮忙归纳总结一下，楼主的翻译是在看不懂。

682256

结论:对于e抗原阴性，但表面抗原还未实现血清转换的病人可以停止用药，但停药后应对病情进行停药后随访检测。

682256

台湾学者论文，既然是Review，所以不是最新研究成果。

StephenW

682256 发表于 2015-6-13 17:31
台湾学者论文，既然是Review，所以不是最新研究成果。

Y.-F. Liaw非常著名的乙肝病毒研究员
J. Hadziyann​​is非常著名的希腊乙肝病毒研究员

停止用NA药有很多的研究。这个评论是一个很好的总结.