血清乙型肝炎核心抗体定量预测慢性乙型肝炎患者非恩替卡

StephenW

J Formos Med Assoc. 2017 Dec 14. pii: S0929-6646(17)30462-X. doi: 10.1016/j.jfma.2017.11.012. [Epub ahead of print]
Quantification of serum hepatitis B core antibody to predict off-entecavir relapse in patients with chronic hepatitis B.
Tseng CH1, Hsu YC2, Chang CY3, Tseng TC4, Wu MS4, Lin JT3, Kao JH5.
Author information

1
    Division of Gastroenterology and Hepatology, E-DA Cancer Hospital/I-Shou University, Kaohsiung, Taiwan.
2
    Division of Gastroenterology and Hepatology, Fu-Jen Catholic University Hospital, New Taipei, Taiwan; School of Medicine and Big Data Research Center, Fu-Jen Catholic University, New Taipei, Taiwan; Graduate Institute of Clinical Medicine, China Medical University, Taichung, Taiwan.
3
    Division of Gastroenterology and Hepatology, Fu-Jen Catholic University Hospital, New Taipei, Taiwan; School of Medicine and Big Data Research Center, Fu-Jen Catholic University, New Taipei, Taiwan.
4
    Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
5
    Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: [email protected].

Abstract
BACKGROUND/PURPOSE:

The predictors of off-therapy response in patients treated with neucleos(t)ide analogue (NA) have not been elucidated. It remained unexplored whether serum level of hepatitis B core antibody (anti-HBc) at the end of NA therapy was associated with relapse risks.
METHODS:

This prospective study monitored 82 chronic hepatitis B (CHB) patients after discontinuing entecavir. All patients had been treated for 3 years or longer and serologically negative for viral DNA and HBeAg at treatment cessation. Patients were monitored for virological relapse (viral DNA > 2000 IU/mL), and clinical relapse (serum alanine aminotransferase > 80 U/L plus virological relapse). The association between anti-HBc levels and the risk of relapse was assessed by the Cox analysis.
RESULTS:

Clinical and virological relapses occurred in 29 and 60 participants, respectively, with the cumulative incidences of 23.7% (95% CI, 15.8-34.6%) and 62.0% (95% CI, 51.5-72.5%) at 1 year, and 36.2% (95% CI, 26.2-48.4%) and 78.8% (95% CI, 68.2-87.8%) at 2 years, respectively. There was a trend for an inverse association between anti-HBc and clinical relapse (crude hazard ratio [HR], 0.50; 95% CI, 0.24-1.05). All 3 patients with the level <100 IU/mL had a rapid clinical relapse (P = 0.002). This trend remained after adjustment for HBsAg and age (adjusted HR 0.50, 95% CI, 0.24-1.03). On the other hand, anti-HBc quantity was unrelated to virological relapse (crude HR, 0.97; 95% CI, 0.58-1.62; adjusted HR, 0.97; 95% CI, 0.58-1.60).
CONCLUSIONS:

This pilot study suggests a trend for an inverse association between anti-HBc levels and clinical relapse in CHB patients off entecavir.

Copyright © 2017. Published by Elsevier B.V.
KEYWORDS:

Anti-HBc quantitation; Antiviral therapy; Chronic hepatitis B

PMID:
    29249417
DOI:
    10.1016/j.jfma.2017.11.012

StephenW

J Formos Med Assoc。 2017 Dec 14。pii：S0929-6646（17）30462-X。 doi：10.1016 / j.jfma.2017.11.012。 [电子版提前打印]
血清乙型肝炎核心抗体定量预测慢性乙型肝炎患者非恩替卡韦复发
Tseng CH1，Hsu YC2，Chang CY3，Tseng TC4，Wu MS4，Lin JT3，Kao JH5。
作者信息

1
    E-DA肿瘤医院/ I-Shou大学，台湾高雄市消化内科和肝病科。
2
    台北新天主教大学附属医院消化科和肝病科;台北新天主教大学医学与大数据研究中心;中国医科大学临床医学研究所台湾台中
3
    台北新天主教大学附属医院消化科和肝病科;台湾新北福仁大学医学与大数据研究中心
4
    台湾台北大学附属医院内科消化科及肝病科。
五
    台湾台北大学附属医院内科消化科及肝病科;台湾台北大学临床医学研究所电子地址：[email protected]。

抽象
背景/目的：

用核苷（酸）类似物（NA）治疗的患者的不治疗反应的预测因子尚未阐明。在NA治疗结束时，乙型肝炎核心抗体（抗-HBc）的血清水平是否与复发风险相关尚未探索。
方法：

该前瞻性研究在停用恩替卡韦后监测了82例慢性乙型肝炎（CHB）患者。所有患者治疗3年或更长时间，治疗停止时病毒DNA和HBeAg血清学阴性。监测患者的病毒学复发（病毒DNA> 2000IU / mL）和临床复发（血清丙氨酸转氨酶> 80U / L加上病毒学复发）。通过Cox分析评估抗-HBc水平与复发风险之间的关联。
结果：

临床和病毒学复发分别发生在29和60名受试者中，1年时累计发生率分别为23.7％（95％CI，15.8-34.6％）和62.0％（95％CI，51.5-72.5％），36.2％ （95％CI，26.2-48.4％）和78.8％（95％CI，68.2-87.8％）。抗-HBc与临床复发之间存在负相关的趋势（粗风险比[HR]，0.50; 95％CI，0.24-1.05）。所有3例<100 IU / mL的患者临床复发迅速（P = 0.002）。调整HBsAg和年龄后，这种趋势仍然存在（调整后的HR 0.50,95％CI，0.24-1.03）。另一方面，抗-HBc量与病毒学复发无关（原始HR为0.97,95％CI为0.58-1.62，调整HR为0.97,95％CI为0.58-1.60）。
结论：

这项初步研究表明抗-HBc水平与恩替卡韦外的CHB患者临床复发之间呈负相关的趋势。

版权所有©2017. Elsevier B.V.
关键词：

抗HBc定量;抗病毒治疗;慢性乙型肝炎

结论：
    29249417
DOI：
    10.1016 / j.jfma.2017.11.012