早期乙型肝炎表面抗原下降预测慢性乙型肝炎患者对恩替卡

StephenW

Sci Rep. 2017 Feb 21;7:42879. doi: 10.1038/srep42879.
Early hepatitis B surface antigen decline predicts treatment response to entecavir in patients with chronic hepatitis B.Peng CY1,2, Lai HC2,3, Su WP2, Lin CH2, Chuang PH2, Chen SH1,2, Chen CH2.
Author information

• 1School of Medicine, China Medical University, Taichung, Taiwan.
• 2Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
• 3School of Chinese Medicine, China Medical University, Taichung, Taiwan.
  

AbstractEarly declines in serum hepatitis B surface (HBsAg) levels, their optimal cutoffs, and association with therapeutic endpoints in chronic hepatitis B (CHB) patients receiving entecavir treatment remain unclear. We prospectively enrolled 529 patients (195 hepatitis B e antigen [HBeAg]-positive and 334 HBeAg-negative) with a median treatment duration of 49.2 months. Median HBsAg levels declined significantly in both groups at Month 3, but only at Months 6-12 in the HBeAg-negative group. Both groups exhibited a significant HBsAg decline with each successive year of treatment. An HBsAg decline of ≥75% from baseline, assessed at Months 3 and 12 of treatment in the HBeAg-positive and -negative patients, respectively, independently predicted a virological response and HBeAg seroconversion in the HBeAg-positive patients, an HBsAg level of <100 IU/mL in the HBeAg-negative patients, and HBsAg loss in all the patients during treatment. HBsAg levels of <3,000 IU/mL at baseline combined with an HBsAg decline of ≥75% from baseline provided a predictive algorithm for HBsAg loss (positive and negative predictive values: 70% and 100%, respectively) during 5 years of treatment. The proposed cutoffs for defining an HBsAg decline may assist clinicians in early assessments of treatment responses in genotype B-infected or C-infected CHB patients receiving entecavir therapy.


PMID:28220833DOI:10.1038/srep42879

StephenW

Sci Rep.2017 Feb 21; 7：42879。 doi：10.1038 / srep42879。
早期乙型肝炎表面抗原下降预测慢性乙型肝炎患者对恩替卡韦的治疗反应。
彭CY1,2，Lai HC2,3，Su WP2，Lin CH2，Chuang PH2，Chen SH1,2，Chen CH2。
作者信息

    中国医科大学学报1，中国台湾台中。
    中国台湾台中医科大学附属医院内科，河北医科大学学报（医学版）。
    中国医科大学中医学院台湾台中。

抽象

在接受恩替卡韦治疗的慢性乙型肝炎（CHB）患者中，血清乙型肝炎表面（HBsAg）水平的早期下降，其最佳截断值以及与治疗终点的关联仍不清楚。我们前瞻性地招募了529名患者（195名乙型肝炎抗原[HBeAg]阳性和334名HBeAg阴性），中位治疗时间为49.2个月。中位HBsAg水平在第3个月时在两组中均显着降低，但仅在HBeAg阴性组中的6-12月时显着降低。两组均在连续的每年治疗中显示出显着的HBsAg下降。在HBeAg阳性和阴性患者中，在治疗的第3和12个月评估HBsAg从基线下降≥75％，分别独立地预测了HBeAg阳性患者中的病毒学应答和HBeAg血清转换，HBsAg水平<在HBeAg阴性患者中为100IU / mL，在治疗期间所有患者中HBsAg消失。在基线时HBsAg水平<3,000 IU / mL，并且HBsAg从基线下降≥75％，提供了在5年治疗期间HBsAg丧失的预测算法（阳性和阴性预测值分别为70％和100％）。所提出的用于定义HBsAg下降的临界值可以帮助临床医生早期评估接受恩替卡韦治疗的基因型B感染或C感染的CHB患者中的治疗反应。

PMID：
    28220833
DOI：
    10.1038 / srep42879

StephenW

http://www.nature.com/articles/srep42879