在非肝硬化慢性乙型肝炎患者中停用核苷类似物后，乙型肝

StephenW

Clin Microbiol Infect. 2017 Dec 26. pii: S1198-743X(17)30688-2. doi: 10.1016/j.cmi.2017.12.013. [Epub ahead of print]
Long-term incidence and predictors of hepatitis B surface antigen loss after discontinuing nucleoside analogues in non-cirrhotic chronic hepatitis B patients.Chen CH1, Hung CH2, Wang JH2, Lu SN2, Hu TH2, Lee CM2.
Author information
1Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taiwan. Electronic address: [email protected].2Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taiwan.

AbstractOBJECTIVES: This study investigates the long-term incidence and predictors for hepatitis B surface antigen (HBsAg) loss after nucleoside analogue (NA) therapy.
METHODS: The study included 411 non-cirrhotic chronic hepatitis B (CHB) patients (148 hepatitis B e antigen (HBeAg)-positive and 263 HBeAg-negative patients) who were treated with lamivudine (n=110) or entecavir (n=301) with post-treatment follow-up of at least 12 months.
RESULTS: In HBeAg-positive patients, the 8-year cumulative rates of virological relapse, clinical relapse, and HBsAg loss were 55.6%, 47.7%, and 19.6%, respectively. In HBeAg-negative patients, the rates were 69.3%, 58.9%, and 33.1%, respectively. Cox regression analysis showed that HBV genotype C and lower end-of-treatment HBsAg levels were independent predictors of HBsAg loss in HBeAg-positive and HBeAg-negative patients. The 5-year HBsAg loss rate was 47.3% in HBeAg-positive patients with end-of-treatment HBsAg levels <300 IU/mL, while the 8-year HBsAg loss rate was 69.3% in HBeAg-negative patients with end-of-treatment HBsAg levels <200 IU/mL. Five patients experienced hepatitis flares with decompensation after stopping NA therapy, and one died after retreatment. Of the 48 patients who developed off-therapy HBsAg loss, 2 developed hepatocellular carcinoma.
CONCLUSIONS: The rate of HBsAg loss was relatively high and the rate of hepatic events was low in non-cirrhotic patients who discontinued NA therapy.

Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

KEYWORDS: antiviral therapy; hepatitis B surface antigen, entecavir; hepatitis B virus; lamivudine

PMID:29288020DOI:10.1016/j.cmi.2017.12.013

StephenW

临床微生物感染。 2017 Dec 26。pii：S1198-743X（17）30688-2。 Doi：10.1016 / j.cmi.2017.12.013。 [电子版提前打印]
在非肝硬化慢性乙型肝炎患者中停用核苷类似物后，乙型肝炎表面抗原丢失的长期发病率和预测因子。
Chen CH1，Hung CH2，Wang JH2，Lu SN2，Hu TH2，Lee CM2。
作者信息

1
高雄长庚医院和长庚大学医学院肝内胃肠科，内科。电子地址：[email protected]。
2
高雄长庚医院和长庚大学医学院肝内胃肠科，内科。

抽象
目的：

本研究调查核苷类似物（NA）治疗后乙型肝炎表面抗原（HBsAg）丢失的长期发病率和预测因子。
方法：

该研究纳入了接受拉米夫定（n = 110）或恩替卡韦治疗后随访的411例非肝硬化慢性乙型肝炎（CHB）患者（148例乙型肝炎e抗原（HBeAg）阳性和263例HBeAg阴性患者）至少12个月。
结果：

在HBeAg阳性患者中，病毒学复发，临床复发和HBsAg消失的8年累积率分别为55.6％，47.7％和19.6％。在HBeAg阴性患者中，发生率分别为69.3％，58.9％和33.1％。 Cox回归分析显示，HBV基因型C和较低的治疗结束时HBsAg水平是HBeAg阳性和HBeAg阴性患者HBsAg消失的独立预测因子。治疗结束时HBsAg水平<300 IU / mL的HBeAg阳性患者5年HBsAg消失率为47.3％，HBeAg阴性终末期患者8年HBsAg消失率为69.3％治疗HBsAg水平<200 IU / mL。停止NA治疗后出现肝功能失代偿失败，复治后死亡。在48名发展为治疗后HBsAg消失的患者中，有2人发展成肝细胞癌。
结论：

在停止NA治疗的非肝硬化患者中，HBsAg消失率相对较高，肝事件发生率较低。

版权©2017欧洲临床微生物学和传染病学会。由Elsevier Ltd.出版。保留所有权利。
关键词：

抗病毒治疗;乙型肝炎表面抗原，恩替卡韦;乙肝病毒;拉米夫定

结论：
29288020
DOI：
10.1016 / j.cmi.2017.12.013