乙肝表面抗原和复发级别恩替卡韦治疗后的慢性HBV感染之间

StephenW

Clin Gastroenterol Hepatol. 2015 Jun 11. pii: S1542-3565(15)00788-0. doi: 10.1016/j.cgh.2015.06.002. [Epub ahead of print]
Association Between Level of Hepatitis B Surface Antigen and Relapse After Entecavir Therapy for Chronic HBV Infection.
Chen CH1, Hung CH1, Hu TH1, Wang JH1, Lu SN1, Su PF2, Lee CM3.
Author information

    1Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, National Cheng Kung University, Taiwan.
    2Department of Statistics, National Cheng Kung University, Taiwan.
    3Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, National Cheng Kung University, Taiwan. Electronic address: [email protected].

Abstract
BACKGROUND & AIMS:

We investigated the rate of relapse of hepatitis B virus (HBV) infection after entecavir therapy for chronic hepatitis B and the association between level of hepatitis B surface antigen (HBsAg) and relapse.
METHODS:

In a retrospective study, we analyzed data from 252 patients with chronic HBV infection who were treated with entecavir and met the Asian Pacific Association for the Study of the Liver treatment stopping rules (mean time, 164±45 weeks), from January 2007 through June 2011 in Taiwan. Eighty-three were hepatitis B e antigen (HBeAg)-positive and 169 were HBeAg-negative. Patients had regular post-treatment follow-up examinations for at least 12 months. Virologic relapse was defined based on serum HBV-DNA >2000 IU/mL after entecavir therapy. Clinical relapse was defined as a level of alanine aminotransferase >2-fold the upper limit of normal and HBV-DNA>2000 IU/mL.
RESULTS:

Two years after therapy ended, 42% of HBeAg-positive patients had a virologic relapse and 37.6% had a clinical relapse; 3 years after therapy ended these rates were 64.3% and 51.6%, respectively. Based on Cox regression analysis, factors independently associated with virologic and clinical relapse included old age, HBV genotype C, and higher baseline levels of HBsAg for HBeAg-positive patients, and old age and higher end-of-treatment levels of HBsAg for HBeAg-negative patients. In HBeAg-positive patients, risk of HBV relapse increased with age ≥40 years and HBsAg level ≥1000 IU/mL at baseline (P<.001). In HBeAg-negative patients, the combination of age (<55 years) and HBsAg level (<150 IU/mL) at the end of treatment was associated with a lower rate of virologic relapse (4.5% of HBeAg-negative patients had viral relapse at year 3). The decreased in level of HBsAg from month 12 of treatment until the end of treatment was greater in patients who did lose HBsAg after entecavir therapy compared to those who did not.
CONCLUSIONS:

The combination of age and level of HBsAg are associated with relapse of HBV infection following treatment with entecavir. HBsAg levels might be used to guide the timing of cessation of entecavir treatment in patients with chronic HBV infection.

Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.
KEYWORDS:

drug; recurrence; reverse transcriptase inhibitor; treatment time

StephenW

临床Gastroenterol肝脏病。 2015年11月PII：S1542-3565（15）00788-0。 DOI：10.1016 / j.cgh.2015.06.002。 [打印EPUB的提前]
乙肝表面抗原和复发级别恩替卡韦治疗后的慢性HBV感染之间的关联。
陈CH1，洪CH1，胡TH1，王JH1，SN1鲁，苏PF2，李CM3。
作者信息

    1区Hepatogastroenterology的，内科，高雄长庚医院与医学长庚​​大学，国立成功大学，台湾系。
    国立成功大学，台湾教研室统计。
    3Division Hepatogastroenterology的，内科，高雄长庚医院与医学长庚​​大学，国立成功大学，台湾系。电子地址：[email protected]。

抽象
背景与目的：

我们调查的乙型肝炎病毒（HBV）感染复发率恩替卡韦治疗慢性乙型肝炎和乙型肝炎表面抗原（HBsAg）和复发的水平之间的关联之后。
方法：

在一项回顾性研究中，我们到六月分析了252例慢性HBV感染谁分别用恩替卡韦，并会见了亚太协会的护肝治疗停止规则的研究（平均时间164±45周），数据2007年1月2011年台湾。八十三是乙肝e抗原（HBeAg）阳性和169为HBeAg阴性。患者有正规治疗后随访检查至少12个月。基于血清HBV-DNA> 2000 IU / mL的恩替卡韦治疗后复发病毒学定义。临床复发被定义为丙氨酸转氨酶>的水平2倍正常和HBV-DNA> 2000 IU /毫升的上限。
结果：

治疗结束两年后，HBeAg阳性患者42％有病毒学复发，37.6％的临床复发;治疗结束后3年，这些比​​率分别为64.3％和51.6％。基于Cox回归分析，病毒学和临床复发独立相关因素包括老年，HBV基因型C和乙肝表面抗原较高的基线水平HBeAg阳性患者，老年和治疗结束的更高水平的HBsAg的个HBeAg-阴性的患者。在HBeAg阳性患者，乙肝复发的风险随着年龄的增长≥40岁，乙肝表面抗原水平≥1000IU / mL的基线（P <0.001）。在HBeAg阴性患者，年龄（<55岁）和乙肝表面抗原水平（<150 IU / mL）的在治疗结束的结合与病毒学复发（HBeAg阴性患者的4.5％的低利率有关联的复发病毒在每年3）。在乙肝表面抗原水平下降的从治疗12个月，直到治疗结束是更大的患者是谁做恩替卡韦治疗相比，谁没输后乙肝表面抗原。
结论：

年龄和乙肝表面抗原水平相结合，与乙肝病毒感染的以下恩替卡韦治疗复发有关。 HBsAg水平可能被用于指导恩替卡韦停止治疗的时机与慢性HBV感染。

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关键词：

药物;复发;逆转录酶抑制剂;治疗时间