治疗后HBV DNA水平可以预测HBeAg阳性慢性乙型肝炎患者HBeAg血清

StephenW

J Chin Med Assoc. 2017 Mar 14. pii: S1726-4901(17)30031-X. doi: 10.1016/j.jcma.2016.12.005. [Epub ahead of print]
On-treatment HBV DNA level could predict HBeAg seroclearance in patients with HBeAg-positive chronic hepatitis B with entecavir therapy.
Huang YJ1, Chang CS2, Peng YC3, Yeh HZ3, Yang SS4.
Author information

1    Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
2    Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, ROC; School of Medicine, Chung-Shan Medical University, Taichung, Taiwan, ROC.
3    Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, ROC; National Yang-Ming University, School of Medicine, Taipei, Taiwan, ROC.
4    Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, ROC; School of Medicine, Chung-Shan Medical University, Taichung, Taiwan, ROC. Electronic address: [email protected].

Abstract
BACKGROUND:

Hepatitis B e antigen (HBeAg) status is associated with clinical outcomes, and seroconversion of HBeAg is one of the treatment goals. In this study, we determined the association of on-treatment serum hepatitis B virus (HBV) DNA levels in HBeAg-positive chronic hepatitis B patients who were receiving entecavir (ETV) treatment.
METHODS:

A retrospective cohort study was conducted involving 135 (78 male and 57 female; mean age, 42.3 ± 13 years) patients with HBeAg-positive chronic hepatitis B (CHB). Between August 2008 and March 2014, each patient was treated with ETV for at least 96 weeks, and their HBV DNA levels were evaluated every 3-6 months. HBeAg seroclearance at the 96th week was defined as an absence of serum HBeAg within 96 weeks after ETV treatment. Univariate and multivariate logistic regression analysis was used to identify the predictors of 96th week HBeAg seroclearance, and a multivariable model was constructed.
RESULTS:

Among the 135 ETV-treated HBeAg-positive CHB patients, 37 patients achieved HBeAg seroclearance (Group 1), whereas 98 patients had persistent HBeAg-positive status (Group 2) at the 96th week check-up. The baseline laboratory data was not significantly different between both the two groups. At the 24th and 48th weeks, there were significant differences between Group 1 and Group 2 in the percentage of patients with HBV DNA levels < 20 IU/mL [17/77 (22.1%) and 11/23 (47.8%), p = 0.032; 45/89 (50.6%) and 26/35 (74.3%), p = 0.028, respectively).
CONCLUSION:

Our study demonstrated that HBV DNA levels < 20 IU/mL at the 24th and 48th weeks could predict serum HBeAg loss in ETV-treated HBeAg-positive patients with CHB.

Copyright © 2017. Published by Elsevier Taiwan LLC.
KEYWORDS:

entecavir; hepatitis B e antigen; hepatitis B virus; hepatitis B virus DNA; seroclearance

PMID:
    28314596
DOI:
    10.1016/j.jcma.2016.12.005

StephenW

J Chin Med Assoc。 2017年3月14日。pii：S1726-4901（17）30031-X。 doi：10.1016 / j.jcma.2016.12.005。 [打印前的电子版]
治疗后HBV DNA水平可以预测HBeAg阳性慢性乙型肝炎患者HBeAg血清清除率。
黄YJ1，Chang CS2，Peng YC3，Yeh HZ3，Yang SS4。
作者信息

台湾台中退伍军人总医院消化内科，内科，1台。
台湾台中退伍军人总医院内科，消化内科2台;中山医科大学医学院，台湾台中，中华民国。
台湾台中退伍军人总医院消化内科，胃肠病科，台湾;国立阳明大学医学院，台北，台湾，中华民国。
台湾台中退伍军人总医院内科，消化内科，四川;中山医科大学医学院，台湾台中，中华民国。电子地址：[email protected]。

抽象
背景：

乙型肝炎病毒抗原（HBeAg）状态与临床结局相关，HBeAg血清学转换是治疗目标之一。在这项研究中，我们确定了接受恩替卡韦（ETV）治疗的HBeAg阳性慢性乙型肝炎患者的治疗血清乙型肝炎病毒（HBV）DNA水平的关联。
方法：

回顾性队列研究涉及135（78男性和57女性;平均年龄，42.3±13年）HBeAg阳性慢性乙型肝炎（CHB）患者。 2008年8月至2014年3月，每位患者接受ETV治疗至少96周，每3-6个月评估一次HBV DNA水平。第96周HBeAg血清白蛋白定义为在ETV治疗后96周内不存在血清HBeAg。单因素和多因素logistic回归分析用于鉴定第96周HBeAg血清白蛋白的预测因子，构建了多变量模型。
结果：

在135例ETV治疗的HBeAg阳性CHB患者中，37名患者达到HBeAg血清清除（组1），而98名患者在第96周检查时具有持续的HBeAg阳性状态（组2）。两组之间的基线实验室数据没有显着差异。在第24周和第48周，第1组和第2组之间在HBV DNA水平<20 IU / mL [17/77（22.1％）和11/23（47.8％），p = 0.032; 45/89（50.6％）和26/35（74.3％），p = 0.028）。
结论：

我们的研究表明，HBV DNA水平<24 IU / mL在第24和48周可以预测血清HBeAg损失ETV治疗HBeAg阳性患者CHB。

版权所有©2017.由Elsevier台湾有限公司出版。
关键词：

恩替卡韦乙型肝炎抗原;乙型肝炎病毒;乙型肝炎病毒DNA;血清学

PMID：
    28314596
DOI：
    10.1016 / j.jcma.2016.12.005