停用替诺福韦和恩替卡韦治疗后，复发率和风险预测因子明

StephenW

Distinct relapse rates and risk predictors after discontinuing tenofovir and entecavir therapy
Tung-Hung Su Hung-Chih Yang Tai-Chung Tseng Jyh-Ming Liou Chen-Hua Liu Chi-Ling Chen Pei-Jer Chen Ding-Shinn Chen Chun-Jen Liu Jia-Horng Kao
The Journal of Infectious Diseases, jix690, https://doi.org/10.1093/infdis/jix690
Published:
02 January 2018

Abstract
Background

We investigated the patterns; predictors for virological relapse (VR), clinical relapse (CR), sustained clinical response (SCR); and retreatment outcomes after nucleos(t)ide analogue (NUC) therapy discontinuation.
Methods

Chronic hepatitis B patients discontinuing NUC were prospectively enrolled. Viral and host predictors, including HBsAg, anti-HBc, the single nucleotide polymorphisms of NTCP (rs2296651), CTLA4 (rs231775), rs3077 (HLA-DPA1), and rs9277535 (HLA-DPB1), and post-therapy predictors were investigated. Patients’ retreatments and outcomes were recorded.
Results

Overall, 100 patients discontinuing 3-year entecavir (ETV) or tenofovir (TDF) therapy were enrolled. Patients discontinuing TDF exhibited significantly higher 3-month VR (52.9% vs. 6.1%, P<0.001) and CR (15.2% vs. 1.5%, P=0.007) rates than those discontinuing ETV, but their 12-month relapse rates were comparable. The end-of-therapy HBsAg levels predicted VR (HR: 1.62; 95%CI: 1.19–2.21), CR (HR: 1.78, 95%CI: 1.13–2.81), and SCR (OR: 0.57, 95%CI: 0.35–0.94). The CTLA4 non-GG genotype predicted VR (HR: 1.74, 95%CI: 1.01–3.00) and CR (HR: 2.06, 95%CI: 1.04–4.11), while rs3077 AA genotype predicted SCR (OR: 10.84, 95%CI: 1.12–105). The 1-month HBV DNA level after NUC cessation is an early predictor of subsequent relapse.
Conclusions

TDF rather than ETV discontinuation is associated with an earlier relapse, and NUC-specific post-therapy monitoring is necessary.

StephenW

停用替诺福韦和恩替卡韦治疗后，复发率和风险预测因子明显不同
苏东红杨大智曾大中曾志明刘晨陈志玲陈培哲陈定新陈春仁刘家弘
“传染病杂志”，jix690，https://doi.org/10.1093/infdis/jix690
发布时间：
2018年1月2日

抽象
背景

我们调查了模式; （VR），临床复发（CR），持续临床反应（SCR）的预测因素;和核苷（酸）类似物（NUC）治疗中止后的再治疗结果。
方法

慢性乙型肝炎患者停止NUC前瞻性招收。研究包括HBsAg，抗-HBc，NTCP（rs2296651），CTLA4（rs231775），rs3077（HLA-DPA1）和rs9277535（HLA-DPB1）的单核苷酸多态性的病毒和宿主预测因子，以及治疗后预测因子。记录患者的退缩和结果。
结果

总体而言，100名停用3年恩替卡韦（ETV）或替诺福韦（TDF）治疗的患者入组。停用TDF的患者比停用ETV的患者的3个月VR显着高于VR患者（52.9％比6.1％，P <0.001）和CR（15.2％比1.5％，P = 0.007），但12个月复发率分别为可比。治疗结束时HBsAg水平预测VR（HR：1.62; 95％CI：1.19-2.21），CR（HR：1.78,95％CI：1.13-2.81）和SCR（OR：0.57,95％CI： 0.35-0.94）。 CTLA4非GG基因型预测VR（HR：1.74,95％CI：1.01-3.00）和CR（HR：2.06,95％CI：1.04-4.11），而rs3077 AA基因型预测SCR（OR：10.84,95％ CI：1.12-105）。 NUC停止后1个月的HBV DNA水平是随后复发的早期预测指标。
结论

TDF而不是ETV停药与较早的复发有关，并且NUC特异性的治疗后监测是必要的。

antiHBVren

也就是说停用替诺福韦，风险更小

kite2002005

哥，你能不用机翻么

StephenW

回复 kite2002005 的帖子

那我该用什么?