在乙肝表面抗原血清学清除发病率种族差异的4737例慢性乙肝

StephenW

Aliment Pharmacol Ther. 2016 Jul 1. doi: 10.1111/apt.13709. [Epub ahead of print]
Ethnic differences in incidence of hepatitis B surface antigen seroclearance in a real-life multicenter clinical cohort of 4737 patients with chronic hepatitis B infection.Nguyen LH1,2, Hoang J3, Nguyen NH4, Vu VD3, Wang C3, Trinh HN5, Li J6, Zhang JQ7, Nguyen MH3.
Author information

• 1Department of Medicine, Stanford University Medical Center, Palo Alto, CA, USA.
• 2Gastrointestinal Unit, Massachusetts General Hospital, Boston, MA, USA.
• 3Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA, USA.
• 4Department of Medicine, University of California, San Diego, San Diego, CA, USA.
• 5San Jose Gastroenterology, San Jose, CA, USA.
• 6Department of Gastroenterology, Palo Alto Medical Foundation, Mountain View, CA, USA.
• 7Chinese Hospital, San Francisco, CA, USA.
  

AbstractBACKGROUND: Hepatitis B surface antigen (HBsAg) positivity is associated with increased risk for cirrhosis and hepatocellular carcinoma (HCC). HBsAg seroclearance is thought to be rare in general, but cohort data from US patients are limited.
AIM: To determine the incidence of HBsAg seroclearance in a real-life US cohort.
METHODS: In total, 4737 patients with chronic hepatitis B from five primary care, gastroenterology and multispecialty centres, and a university medical centre were retrospectively enrolled between 2001 and 2014 with data obtained by manual review of individual patient medical records. Seroclearance was determined by loss of HBsAg seropositivity. Persistent HBsAg was confirmed by direct serology or by proxy with positive hepatitis B e-antigen (HBeAg) or HBV DNA levels.
RESULTS: HBsAg seroclearance occurred in 52 patients over 16 844 person-years (0.31% annually, 1.2% overall). Median follow-up was 32 months, and mean age 45 ± 14 years. Incidence of HBsAg seroclearance was higher in non-Asians, age >45, males, and those with baseline HBV DNA ≤10 000 IU/mL. On multivariate Cox proportional modelling, non-Asian ethnicity (HR 2.8), male sex (HR 2.1), baseline HBVDNA ≤10 000 (HR 2.0) and age >45 (HR 1.8) were significant independent predictors of seroclearance.
CONCLUSION: HBsAg seroclearance rates were lower than previously described in this real-life cohort of patients with chronic hepatitis B, especially among Asian, female and younger patients.
© 2016 John Wiley & Sons Ltd.


PMID:27363288DOI:10.1111/apt.13709

StephenW

滋养品药理疗法。 2016年1月DOI：10.1111 / apt.13709。 [打印EPUB提前]
在乙肝表面抗原血清学清除发病率种族差异的4737例慢性乙肝感染现实生活中的多中心临床队列。
阮LH1,2，晃J3，阮NH4，武VD3，王C3，郑氏HN5，李J6，张JQ7，阮MH3。
作者信息

    医药，斯坦福大学医学中心，帕洛阿尔托，CA，USA教研室。
    2Gastrointestinal单位，马萨诸塞州总医院，波士顿，MA，USA。
    胃肠病学和肝病，斯坦福大学医学中心，帕洛阿尔托，CA，USA的3Division。
    医学，加州大学圣地亚哥分校，圣地亚哥，CA，USA的4Department。
    5San何塞消化内科，圣何塞，CA，USA。
    消化内科，帕洛阿尔托医学基金会，山景，CA，USA的6Department。
    7Chinese医院，旧金山，CA，USA。

抽象
背景：

乙型肝炎表面抗原（HBsAg）阳性与用于肝硬化和肝细胞癌的风险增加（HCC）相关联。乙肝表面抗原血清学清除被认为是罕见的一般，但美国患者队列的数据是有限的。
目标：

为了确定在现实生活中的美国队列的HBsAg血清清除的发生率。
方法：

总体而言，4737例慢性乙型肝炎从五个初级保健，胃肠病学和多专业中心，一所大学医疗中心2001年至2014年间进行了回顾性入选由个别病人的医疗记录人工审核获得的数据。血清学清除是由乙肝表面抗原血清阳性的损失确定。持久性的HBsAg通过直接血清学或通过用阳性乙型肝炎e抗原（HBeAg的）或HBV DNA水平代理确认。
结果：

乙肝表面抗原血清学清除52例患者发生了16 844人 - 年（0.31％，每年1.2％的整体）。中位随访期为32个月，平均年龄45±14年。乙肝表面抗原血清学清除的发病率为非亚裔高，年龄> 45岁，男性，和那些与基线HBV DNA≤10000国际单位/毫升。在多变量Cox比例造型，非亚裔（HR 2.8），男性（HR 2.1），基线HBVDNA≤10000（HR 2.0）和年龄> 45（HR 1.8）为血清学清除的显著独立预测因素。
结论：

乙肝表面抗原血清学清除率比以前在慢性乙肝这个现实生活队列描述下，尤其是在亚洲，女性和年轻患者。

2016年©约翰·威利父子有限公司

结论：
    27363288
DOI：
    10.1111 / apt.13709