APASL2016:表面抗原损耗率很高，seroreversion率较低 亚洲的慢性HB

StephenW

O-108
High rates of surface antigen loss, low rates of seroreversion
in Asian chronic HBV patients
Robert Gish1, Robert Wong2, My Nguyen3, Huy Trinh4, Andrew
Huynh3, Mytop Ly2, Huy Nguyen4, Khanh Nguyen4, Jenny Yang4,
Ruel Garcia4, Brian Levitt4, Eduardo DaSilvera4
1Division of Gastroenterology and Hepatology, Stanford University,
Stanford, Ca, USA; 2Division of Gastroenterology and Hepatology,
Alameda Health System Highland Hospital, Oakland, Ca, USA;
3Silicon Valley Research Institute, San Jose, Ca, USA; 4San Jose
Gastroenterology, San Jose, CA, USA
Background: Chronic hepatitis B virus (HBV) infection is a global
disease with the majority from Asian-Pacific regions. It is unclear if
HBV surface antigen (HBsAg) loss alone correlates well with undetectable
virus, normalization of alanine aminotrasferase (ALT) on
treatment, future development of anti-HBs, nor is the risk of seroreversion
or detectable virus after stopping therapy well defined.
Methods: We retrospectively evaluated 958 chronic HBV adults on
oral antiviral therapy at a community gastroenterology clinic from
1997–2015. 99.6 % were Asian ethnicity. Rates of HBsAg loss, ALT
normalization, achieving undetectable virus, and developing surface
antibody (anti-HBs) were stratified by HBeAg status. Following
HBsAg loss, rates of HBsAg seroreversion and/or re-emergence of
detectable virus were analyzed.
Results: With a mean 86.6 months follow-up and mean treatment
duration of 81.2 months, overall HBsAg loss was 4.91 % (n = 47),
with similar rates between HBeAg positive (4.43 %) and negative
patients (5.14 %), p = 0.63. Among HBsAg loss patients, 31.8 %
developed anti-HBs, 97.9 % achieved undetectable virus, 66.0 %
normalized ALT. 19 patients had both HBsAg and anti-HBs positivity.
2.1 %(n = 1) who achieved HBsAg loss had detectable virus, whereas
12.8 % (n = 6) of HBsAg loss patients seroreverted with positive
HBsAg within 1–17 months. All 6 patients who seroreverted had sustained
undetectable virus, and 1/6 had positive anti-HBs prior to
seroreversion. Anti-HBs status did not predict HBsAg seroreversion.
Conclusion: Among this Asian patient population, treatment of
chronic HBV achieved 4.91 % HBsAg loss. While 12.8 % of patients
experienced seroreversion, all maintained undetectable virus,
demonstrating the sustainability of HBsAg loss in most patients and
stable suppression of HBV virus.

StephenW

O-108
表面抗原损耗率很高，seroreversion率较低
亚洲的慢性HBV患者
罗伯特Gish1，罗伯特Wong2，我Nguyen3，伊Trinh4，安德鲁
Huynh3，Mytop LY2，伊Nguyen4，庆Nguyen4，珍妮Yang4，
鲁埃尔Garcia4，布莱恩Levitt4，爱德华多DaSilvera4
胃肠病学和肝病，斯坦福大学的1区，
斯坦福大学，CA，USA;胃肠病学和肝病的2区，
阿拉米达卫生系统高地医院，奥克兰，CA，USA;
3硅谷研究所，圣何塞，CA，USA; 4San何塞
消化内科，圣何塞，CA，USA
背景：慢性乙型肝炎病毒（HBV）感染是一个全球性
疾病主要来自亚太地区。目前还不清楚，如果
乙肝病毒表面抗原（HBsAg）的损失单独检测不到很好的相关性
病毒，丙氨酸氨基转移酶（ALT）的正常化
治疗，抗-HBs未来发展，也不是seroreversion的风险
或停止治疗后检测病毒明确界定。
方法：我们回顾性评价958慢性乙肝的成年人
从社区消化内科门诊口服抗病毒治疗
1997年至2015年。 99.6％是亚裔。 HBsAg转阴率，ALT
规范化，实现了检测不到病毒，发展面
抗体（抗-HBs）由HBeAg状态分层。以下
HBsAg转阴，乙肝表面抗原seroreversion和/或重新出现率
可检测的病毒进行分析。
结果：平均86.6个月跟进和平均治疗
的81.2个月持续时间，总体HBsAg消失是4.91％（N = 47），
HBeAg阳性（4.43％）和负极之间的相似率
例（5.14％），p值= 0.63。在HBsAg消失患者中，31​​.8％
发达的抗-HBs，97.9％，实现了检测不到病毒，66.0％
标准化ALT。 19例HBsAg和抗-HBs阳性。
2.1％（N = 1）谁取得HBsAg消失了检测病毒，而
12.8％（6例）的HBsAg转阴患者seroreverted阳性
1-17个月内的HBsAg。所有6例患者谁seroreverted有持续
检测不到病毒，和1/6有阳性抗HBs前
seroreversion。抗-HBs状态并不能预测的HBsAg seroreversion。
结论：在本次亚运会的患者人群，治疗
慢性HBV达到4.91％，HBsAg消失。虽然患者的12.8％
经验丰富的seroreversion，均保持检测不到病毒，
证明HBsAg消失的大多数患者的可持续性和
乙肝病毒的稳定抑制。