核苷类似物治疗过程中乙型肝炎表面抗原血清学清除：表面

StephenW

Original Article—Liver, Pancreas, and Biliary Tract

Journal of Gastroenterology

May 2016, Volume 51, Issue 5, pp 487-495

First online: 07 October 2015
Hepatitis B surface antigen seroclearance during nucleoside analogue therapy: surface antigen kinetics, outcomes, and durability

    Wai-Kay Seto , Ka-Shing Cheung, Danny Ka-Ho Wong, Fung-Yu Huang, James Fung, Kevin Sze-Hang Liu, Ching-Lung Lai, Man-Fung Yuen


Abstract
Background

Hepatitis B surface antigen (HBsAg) seroclearance is the recommended treatment end point for nucleoside analogue (NA) therapy in chronic hepatitis B, yet the underlying kinetics and durability of HBsAg seroclearance in NA-treated patients have not been well described.
Methods

We compared the HBsAg kinetics and long-term serologic outcomes of 51 chronic hepatitis B patients achieving HBsAg seroclearance during NA therapy with those of 51 HBsAg-positive controls, matched for age, sex, hepatitis B e antigen status, NA type, and treatment duration. Viral profiles before and after HBsAg seroclearance during and after NA treatment cessation were determined.
Results

The median time to HBsAg seroclearance and the median follow-up duration after HBsAg seroclearance were 61.2 and 51.6 months respectively. Patients achieving HBsAg seroclearance maintained high median rates of HBsAg reduction throughout therapy (first 6 months, 0.40 IU/mL/year; after year 1, 0.39 IU/mL/year; p = 0.809). For controls, the median rate of HBsAg reduction was significantly slower with time (first 6 months and after year 1, 0.19 and 0.05 IU/mL/year; p = 0.006). The difference in the median HBsAg reduction rates after year 1 between the two groups was significant (p < 0.001). The cumulative rates of antibody to HBsAg development and HBsAg seroreversion 72 months after HBsAg seroclearance were 68.9 and 8.3 % (one patient receiving immunosuppressive therapy; one patient with pre-S/S variant), respectively. Among 22 patients who discontinued therapy after HBsAg seroclearance, 21 remained HBsAg negative with undetectable hepatitis B virus DNA and one patient with reactivation had the pre-S/S variant.
Conclusion

NA-treated patients achieving HBsAg seroclearance uniquely maintained high rates of HBsAg reduction throughout treatment, with HBsAg seroclearance durable in most of the patients after treatment cessation.
Keywords
Hepatitis B virus Hepatitis B surface antigen Antibody to hepatitis B surface antigen Covalently closed circular DNA Antiviral

StephenW

原创文章 - 肝脏，胰腺和胆道

胃肠病学杂志

2016年5月，51卷，第5期，第487-495

首先在线：2015年10月07日
核苷类似物治疗过程中乙型肝炎表面抗原血清学清除：表面抗原动力学，结果和耐用性

    伟凯濑户，李嘉诚翔，丹尼家豪皇，丰禹皇，丰詹姆斯，凯文思航刘晴龙丽，满凤园


抽象
背景

乙型肝炎表面抗原（HBsAg）血清学清除是用于慢性乙型肝炎核苷类似物（NA）治疗建议的治疗终点，但在NA处理的患者的基本动力学与HBsAg血清清除的耐久性没有得到很好的说明。
方法

我们比较了HBsAg的动力学和51慢性乙型肝炎患者的NA疗法与51 HBsAg阳性对照，年龄，性别，乙肝e抗原状态，NA类型，治疗持续时间相匹配时实现的HBsAg血清清除长期血清学结果。之前和期间和之后的NA治疗停止的HBsAg血清清除后病毒型材进行了测定。
结果

中位时间为乙肝表面抗原血清学清除及HBsAg血清清除后中位随访时间分别为61.2 51.6个月时。患者的HBsAg实现转阴保持的HBsAg降低高值率在整个治疗（前6个月，0.40 IU /毫升/年; 1年后，0.39 IU /毫升/年; P = 0.809）。为对照，乙肝表面抗原减少的位率为显著慢随时间（在前6个月和1年，0.19和0.05单位/毫升/年后; P = 0.006）。中位数HBsAg的减少率今年1后两组比较差异有显著（P <0.001）。抗体的累积率对HBsAg发展与HBsAg seroreversion HBsAg的血清清除后72个月时68.9和8.3％（其中，患者接受免疫抑制剂治疗; 1例前S / S的变体），分别。其中22例谁后停止治疗乙肝表面抗原血清学清除，21仍HBsAg阴性检测不到乙肝病毒DNA和1例激活了前S / S的变种。
结论

NA处理的患者达到的HBsAg血清清除唯一保持的HBsAg还原率高整个治疗，用HBsAg血清清除在大部分患者持久治疗停止之后。
关键词
乙肝病毒B型肝炎表面抗原的抗体对乙肝表面抗原共价闭合环状DNA抗病毒