慢性乙型肝炎患者停用替诺福韦治疗后HBV复发的发生率和预

StephenW

J Viral Hepat. 2017 Dec 23. doi: 10.1111/jvh.12851. [Epub ahead of print]
The incidence and predictors of HBV relapse after cessation of tenofovir therapy in chronic hepatitis B patients.Chen CH1, Hsu YC2, Lu SN1, Hung CH1, Wang JH1, Lee CM1, Hu TH1.
Author information
1Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine.2Division of Gastroenterology, E-Da Hospital, Kaohsiung, Taiwan.

AbstractThis study investigates the incidences and predictors of hepatitis B virus (HBV) relapse after tenofovir disoproxil fumarate (TDF) therapy in hepatitis B e antigen (HBeAg)-positive and -negative patients. We retrospectively recruited 143 chronic hepatitis B (CHB) patients without cirrhosis (39 HBeAg-positive and 104 HBeAg-negative patients) who were previously treated with TDF and had post-treatment follow-up for at least 6 months (median: 55, IQR 36-85 weeks). All the patients fulfilled the stopping criteria of APASL 2012. The virological and clinical relapse rates at 104 weeks in HBeAg-positive patients were 66.6% and 59.1%, while they were 72.3% and 55.9%, respectively, in HBeAg-negative patients. Cox regression analysis revealed that the higher end-of-treatment HBsAg levels was an independent factor of virological relapse in HBeAg-positive and HBeAg-negative patients. The end-of-treatment HBsAg of 200 (area under the receiver-operating characteristic (AUROC): 0.624) and 80 IU/mL (AUROC: 0.959) were the optimal values for predicting HBV relapse in HBeAg-positive and HBeAg-negative patients, respectively. The virological relapse rate at 78 weeks was 14.3% and 19.6% in HBeAg-positive and HBeAg-negative patients who achieved HBsAg ≤200 IU/mL and HBsAg ≤80 IU/mL, respectively. Two patients experienced hepatic decompensation upon hepatitis flares, and no patient died after timely re-treatment. Seven patients experienced off-therapy HBsAg loss. The cumulative rates of HBsAg loss at 104 weeks were 45.5% and 59.3% in patients with end-of-treatment HBsAg ≤80 IU/mL and ≤50 IU/mL, respectively. In conclusions, the end-of-treatment HBsAg levels was a useful marker for predicting HBV relapse in HBeAg-positive and HBeAg-negative CHB patients. This article is protected by copyright. All rights reserved.


KEYWORDS: clinical relapse; hepatitis B surface antigen; hepatitis B virus; tenofovir; virological relapse

PMID:29274189DOI:10.1111/jvh.12851

StephenW

J病毒肝脏。 2017 Dec 23。doi：10.1111 / jvh.12851。 [电子版提前打印]
慢性乙型肝炎患者停用替诺福韦治疗后HBV复发的发生率和预测因素。
Chen CH1，Hsu YC2，Lu SN1，Hung CH1，Wang JH1，Lee CM1，Hu TH1。
作者信息

1
    长庚大学医学院高雄长庚医院肝内胃肠科内科。
2
    高雄市艾达医院消化科。

抽象

本研究调查乙酰丁酸乙酯e抗原（HBeAg）阳性和阴性患者替诺福韦酯富马酸（TDF）治疗后乙型肝炎病毒（HBV）复发的发生率和预测因子。我们回顾性分析了143例既往接受过TDF治疗的肝硬化患者（39例HBeAg阳性和104例HBeAg阴性）的慢性乙型肝炎（CHB）患者，治疗后随访至少6个月（中位数为55，IQR 36-85周）。所有患者符合APASL2012的停药标准。HBeAg阳性患者在104周时的病毒学和临床复发率分别为66.6％和59.1％，而HBeAg阴性患者分别为72.3％和55.9％。 Cox回归分析显示，治疗结束时HBsAg水平较高是HBeAg阳性和HBeAg阴性患者病毒学复发的独立因素。 200（接受者操作特征（AUROC）：0.624）和80 IU / mL（AUROC：0.959）的治疗结束HBsAg是预测HBeAg阳性和HBeAg阴性患者中HBV复发的最佳值， 分别。 HBsAg≤200 IU / mL，HBsAg≤80 IU / mL的HBeAg阳性和HBeAg阴性患者在78周时的病毒学复发率分别为14.3％和19.6％。 2例肝炎后出现肝功能失代偿，未及时再治疗死亡。有7名患者经历了治疗前HBsAg消失。治疗结束时HBsAg≤80IU / mL和≤50IU / mL的患者在104周时的HBsAg消失累积率分别为45.5％和59.3％。结论：治疗结束时HBsAg水平是预测HBeAg阳性和HBeAg阴性CHB患者HBV复发的有用指标。本文受版权保护。版权所有。
关键词：

临床复发;乙肝表面抗原;乙肝病毒;替诺福韦;病毒复发

结论：
    29274189
DOI：
    10.1111 / jvh.12851