亚洲慢性乙型肝炎患者的乙型肝炎表面抗原损失和持续病毒

StephenW

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        J Viral Hepat. 2017 Jun 5. doi: 10.1111/jvh.12736. [Epub ahead of print]
Hepatitis B Surface Antigen Loss and Sustained Viral Suppression in Asian Chronic Hepatitis B Patients: A Community-Based Real World Study.Wong RJ1, Nguyen MT2, Trinh HN3, Chan C1, Huynh A2, Ly MT2, Nguyen HA3, Nguyen KK3, Torres S1, Yang J3, Liu B1, Garcia RT3, Bhuket T1, Baden R1, Levitt B3, da Silveira E3, Gish RG4,5.
Author information
1Division of Gastroenterology and Hepatology, Alameda Health System - Highland Hospital, Oakland, California, USA.2Silicon Valley Research Institute, San Jose, California, USA.3San Jose Gastroenterology, San Jose, California, USA.4Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, Stanford, California, USA.5Hepatitis B Foundation, Doylestown, Pennsylvania, USA.

AbstractCommunity-based real-world outcomes on effectiveness of antiviral therapies for chronic hepatitis B virus (CHB) in Asians are limited. Whether hepatitis B surface antigen (HBsAg) loss correlates with undetectable virus and alanine aminotransferase (ALT) normalization on treatment or what predicts risk of seroreversion or detectable virus after stopping therapy is unclear. We aim to evaluate rates and predictors of HBsAg loss, seroconversion, ALT normalization and undetectable HBV DNA, including HBsAg seroreversion or re-emergence of HBV DNA among Asian CHB patients. We retrospectively evaluated 1,072 CHB adults on antiviral therapy at two community gastroenterology clinics from 1997-2015. Rates of HBsAg loss, ALT normalization, achieving undetectable HBV DNA, and developing surface antibody (anti-HBs) were stratified by HBeAg status. Following HBsAg loss, HBsAg seroreversion or re-emergence of detectable HBV DNA were analyzed. With median treatment of 76.7 months, the overall rate of HBsAg loss was 4.58%, with similar HBsAg loss rates between HBeAg-positive and HBeAg-negative patients (4.44% vs. 4.71%, p=0.85) in a predominantly Asian population (98.1%). Among HBsAg loss patients, 33.3% developed anti-HBs, 95.8% achieved undetectable virus, and 66.0% normalized ALT. No significant baseline or on-treatment predictors of HBsAg loss were observed. While 6 patients who achieved HBsAg loss had seroreversion with re-emergence of HBsAg positivity, viral load remained undetectable, demonstrating the sustainability of viral suppression. Among a large community-based real-world cohort of Asian CHB patients treated with antiviral therapy, rate of HBsAg loss was 4.58%. Despite only 33.3% of HBsAg loss patients achieving anti-HBs, nearly all patients achieved sustained undetectable virus. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.

KEYWORDS: HBV; Asians; oral antivirals; surface antigen; viral suppression

PMID:28581644DOI:10.1111/jvh.12736

StephenW

J病毒肝2017年6月5日。doi：10.1111 / jvh.12736。 [提前印刷]
亚洲慢性乙型肝炎患者的乙型肝炎表面抗原损失和持续病毒抑制：基于社区的现实世界研究。
Wong RJ1，Nguyen MT2，Trinh HN3，Chan C1，Huynh A2，Ly MT2，Nguyen HA3，Nguyen KK3，Torres S1，Yang J3，Liu B1，Garcia RT3，Bhuket T1，Baden R1，Levitt B3，da Silveira E3，Gish RG4,5。
作者信息

1
    美国加利福尼亚州奥克兰市高地医院Alameda健康系统消化内科和肝病科。
2
    硅谷研究所，美国加利福尼亚州圣荷西。
3
    San Jose Gastroenterology，San Jose，California，USA。
4
    美国加利福尼亚州斯坦福大学斯坦福大学医学中心消化内科和肝病学系。
五
    乙型肝炎基金会，宾夕法尼亚州Doylestown，美国。

抽象

针对亚洲人慢性乙型肝炎病毒（CHB）的抗病毒疗法有效性的社区现实结果有限。乙型肝炎表面抗原（HBsAg）损失是否与不可检测的病毒和丙氨酸氨基转移酶（ALT）正常化相关，或者停止治疗后预测血清转换或可检测病毒的风险是不清楚的。我们的目标是评估亚洲CHB患者HBsAg损失，血清转换，ALT正常化和HBV DNA检测率，包括HBsAg血清转换或HBV DNA再次出现的发生率和预测因子。我们回顾性地评估了1997年至2015年两个社区胃肠病诊所的1,072名CHB成年人抗病毒治疗。 HBsAg损失率，ALT正常化，实现无法检测的HBV DNA，以及发展中的表面抗体（抗-HBs）均由HBeAg状态分层。在HBsAg损失后，分析HBsAg血清转换或可检测HBV DNA的再次出现。中位数为76.7个月，HBsAg总体失血率为4.58％，HBeAg阳性和HBeAg阴性患者的HBsAg损失率分别为4.38％，4.71％，P = 0.85）（98.1％） ％）。 HBsAg损失患者中，33.3％发生抗HBs，95.8％达不到预期病毒，66.0％正常ALT。没有观察到HBsAg损失的显着基线或治疗预测因子。 HBsAg阳性患者6例HBsAg阳性患者血清反转，病毒载量依然无法检测，表现为病毒抑制的可持续性。在以抗病毒治疗方法治疗的亚洲CHB患者中，以社区为基础的现实世界队伍中，HBsAg损失率为4.58％。尽管只有33.3％的HBsAg损失患者达到抗HBs，但几乎所有患者均获得了持续的无法检测的病毒。本文受版权保护。版权所有。

本文受版权保护。版权所有。
关键词：

HBV;亚洲人;口服抗病毒药表面抗原病毒抑制

结论：
    28581644
DOI：
    10.1111 / jvh.12736