乙肝表面抗原定量的乙肝e抗原血清学转换恩替卡韦治疗乙型

StephenW

Int J Infect Dis. 2015 Oct 30. pii: S1201-9712(15)00253-2. doi: 10.1016/j.ijid.2015.10.019. [Epub ahead of print]
Hepatitis B surface antigen quantification at hepatitis B e antigen seroconversion predicts virological relapse after the cessation of entecavir treatment in hepatitis B e antigen-positive patients.Qiu YW1, Huang LH1, Yang WL2, Wang Z1, Zhang B1, Li YG1, Su TT1, Zhou HY1, Xu W1, Wang XD1, Dai YP1, Gan JH3.
Author information

• 1The Wuxi Fifth Affiliated Hospital of Jiangnan University, Wuxi 214005, Jiangsu Province, China.
• 2The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China.
• 3The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China. Electronic address: [email protected].
  


AbstractOBJECTIVES: To assess off-treatment virological relapse rates and to determine the role of hepatitis B surface antigen (HBsAg) quantification in predicting virological relapse after stopping entecavir(ETV) treatment in patients with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B(CHB).
METHODS: We enrolled 112 CHB patients in whom ETV was stopped according to APASL guideline stopping rules. Patients had HBsAg and HBV DNA levels were monitored every 4-12 weeks during ETV treatment and after ETV cessation. Post-treatment virological relapse was defined as a serum HBV DNA level of >10,000 copies/mL after stopping ETV treatment.
RESULTS: Virological relapse rate at 52 weeks after stopping ETV was 48.2%. The post-treatment virological relapse rate was significantly higher in patients age >50 years than in those <50 years (P<0.001),and the virological relapse rate was significantly lower in patients HBsAg level <2.0 log10 IU/mL than in those≥2.0 log10 IU/mL at ETV cessation (P=0.005) .HBsAg level of 2.5 log10 IU/mL at HBeAg seroconversion was the optimal cut-off value for predicting post-treatment virological relapse (P<0.001). In those age<50 and HBsAg level≤2.5 log10 IU/mL at HBeAg seroconversion, the relapse rate only 5%. In those HBsAg level≤2.5 log10 IU/mL at HBeAg seroconversion,52.4% patients achieved HBsAg levels≤2.0 log10 IU/mL at ETV cessation. While in those HBsAg >2.5 log10 IU/mL at HBeAg seroconversion, only 4.4% patients achieved that criteria.
CONCLUSIONS: HBsAg levels can help guide the timing of cessation of ETV treatment. HBsAg levels of 2.5log10 IU/mL at HBeAg seroconversion may be a useful marker to predict virological relapse after the cessation of ETV treatment in HBeAg-positive CHB patients.
Copyright © 2015. Published by Elsevier Ltd.


KEYWORDS: chronic hepatitis B; entecavir; relapse ;hepatitis B surface antigen; withdrawal

PMID:26523639 [PubMed - as supplied by publisher]  


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StephenW

诠释J传染病杂志。 2015年30月PII：S1201-9712​​（15）00253-2。 DOI：10.1016 / j.ijid.2015.10.019。 [打印EPUB提前]
乙肝表面抗原定量的乙肝e抗原血清学转换恩替卡韦治疗乙型肝炎e抗原阳性的患者停止后预测病毒学复发。
邱YW1，黄LH1，杨WL2，王Z1，B1张，李YG1，苏TT1，周HY1，徐W1，王XD1，戴YP1，甘JH3。
作者信息

    1The江南大学，无锡214005，中国江苏省无锡市第五附属医院。
    南昌大学，南昌，江西，中国的2The第二附属医院。
    苏州大学，苏州215006，江苏省，中国的3The第一附属医院。电子地址：[email protected]。

抽象的
目的：

为了评估过治疗的病毒学复发率，并确定患者的乙型肝炎e抗原（HBeAg）阳性的慢性乙肝停药恩替卡韦（ETV）治疗后预测病毒学复发的乙肝表面抗原（HBsAg）定量的作用（CHB ）。
方法：

我们参加了其中ETV根据APASL指南停止规则停止112例慢性乙型肝炎患者。患者不得不在ETV治疗和ETV停止后HBsAg和HBV DNA水平进行了监测每隔4-12周。治疗后复发病毒学被定义为> 10,000份血清HBV DNA水平/ mL的ETV停止治疗后。
结果：

病毒学复发率在第52周停药ETV后为48.2％。后处理病毒学复发率显著高于患者年龄比那些> 50岁<50岁（P <0.001），和病毒学复发率为患者显著较低的HBsAg水平<2.0日志10国际单位/毫升比those≥ 2.0日志10 IU / mL的在ETV停止（P = 0.005）2.5日志10 IU / mL的在HBeAg血清转换.HBsAg水平是预测治疗后病毒学复发的最佳临界值（P <0.001）。在那些年龄<50与HBsAglevel≤2.5日志10 IU / mL的在HBeAg血清学转换，复发率只有5％。在那些乙肝表面抗原level≤2.5日志10 IU / mL的在HBeAg血清转换，52.4％的患者在ETV戒烟达到乙肝表面抗原levels≤2.0日志10 IU / mL的。而在那些乙肝表面抗原> 2.5日志10 IU / mL的在HBeAg血清学转换，只有4.4％的患者达到这一标准。
结论：

HBsAg水平有助于指导戒烟ETV治疗的时机。 HBsAg水平的2.5log10 IU / mL的在HBeAg血清学转换可能是一个有用的标志ETV治疗HBeAg阳性慢性乙型肝炎患者停止后预测病毒学复发。

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关键词：

慢性乙型肝炎;恩替卡韦;复发;乙型肝炎表面抗原;撤离