在HBeAg血清学转换后停止白种人乙型肝炎患者的核苷（酸）类

StephenW

Aliment Pharmacol Ther. 2018 Mar 2. doi: 10.1111/apt.14560. [Epub ahead of print]
Stopping nucleos(t)ide analogue treatment in Caucasian hepatitis B patients after HBeAg seroconversion is associated with high relapse rates and fatal outcomes.Van Hees S1,2, Bourgeois S1, Van Vlierberghe H3, Sersté T4, Francque S1, Michielsen P1, Sprengers D1, Reynaert H4, Henrion J5, Negrin Dastis S6, Delwaide J7, Lasser L4, Decaestecker J8, Orlent H9, Janssens F10, Robaeys G11, Colle I12, Stärkel P4, Moreno C4, Nevens F13, Vanwolleghem T1,2; Belgian NA Stop Study Group.
Collaborators  (21)

Van Hees S, Bourgeois S, Van Vlierberghe H, Sersté T, Francque S, Michielsen P, Sprengers D, Reynaert H, Henrion J, Negrin-Dastis S, Delwaide J, Lasser L, Decaestecker J, Orlent H, Janssens F, Robaeys G, Colle I, Stärkel P, Moreno C, Nevens F, Vanwolleghem T.

Author information
1Antwerp, Belgium.2Rotterdam, The Netherlands.3Ghent, Belgium.4Brussels, Belgium.5Jolimont, Belgium.6Charleroi, Belgium.7Liège, Belgium.8Roeselare, Belgium.9Brugge, Belgium.10Hasselt, Belgium.11Genk, Belgium.12Aalst, Belgium.13Leuven, Belgium.

AbstractBACKGROUND: Stopping nucleos(t)ide analogues (NA) after hepatitis B e antigen (HBeAg) seroconversion is associated with high relapse rates in Asian patients, but data in Caucasian cohorts are scarce. Clinical course, outcomes and immunological aspects of chronic hepatitis B infections differ substantially between distinct ethnicities.
AIM: The aim of this study was to determine relapse rates, factors predicting relapse and clinical outcomes after nucleos(t)ide analogue cessation in a large, predominantly Caucasian cohort of chronic hepatitis B patients with nucleos(t)ide analogue-induced HBeAg seroconversion.
METHODS: This is a nationwide observational cohort study including HBeAg positive, mono-infected chronic hepatitis B patients with nucleos(t)ide analogue-induced HBeAg seroconversion from 18 centres in Belgium.
RESULTS: A total of 98 patients with nucleo(s)tide analogue-induced HBeAg seroconversion were included in the study. Of the 62 patients who stopped treatment after a median consolidation treatment of 8 months, 30 relapsed. Higher gamma-glutamyl transferase levels at both treatment initiation (HR 1.004; P = 0.001 per unit increment) and HBeAg seroconversion (HR 1.006; P = 0.013 per unit increment) were associated with an increased risk of clinically significant relapse in a multivariate Cox regression model. Treatment cessation led to liver-related death in 2 patients, of whom one showed a severe flare. Of the patients who continued treatment after HBeAg seroconversion, none relapsed or developed severe hepatic outcomes.
CONCLUSION: Treatment withdrawal in Caucasian chronic hepatitis B patients after nucleos(t)ide analogue-induced HBeAg seroconversion results in viral relapses in more than half of patients with potential fatal outcomes. These real-world data further lend support to preferentially continue NA treatment after HBeAg seroconversion until HBsAg loss.

© 2018 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd.

PMID:29498078DOI:10.1111/apt.14560

StephenW

Aliment Pharmacol Ther。 2018年3月2日：doi：10.1111 / apt.14560。 [电子版提前打印]
在HBeAg血清学转换后停止白种人乙型肝炎患者的核苷（酸）类似物治疗与高复发率和致命结果相关。
Van Hees S1,2，Bourgeois S1，Van Vlierberghe H3，SerstéT4，Francque S1，Michielsen P1，Sprengers D1，Reynaert H4，Henrion J5，Negrin Dastis S6，Delwaide J7，Lasser L4，Decaestecker J8，Orlent H9，Janssens F10， Robeeys G11，Colle I12，StärkelP4，Moreno C4，Nevens F13，Vanwolleghem T1,2;比利时不适用停止研究组。
合作者（21）

Van Hees S，Bourgeois S，Van Vlierberghe H，SerstéT，Francque S，Michielsen P，Sprengers D，Reynaert H，Henrion J，Negrin-Dastis S，Delwaide J，Lasser L，Decaestecker J，Orlent H，Janssens F，Robeeys G，Colle I，StärkelP，Moreno C，Nevens F，Vanwolleghem T.
作者信息

1
比利时安特卫普。
2
荷兰鹿特丹。
3
比利时根特。
4
布鲁塞尔，比利时。
五
Jolimont，比利时。
6
比利时沙勒罗瓦。
7
列日，比利时。
8
鲁塞拉雷，比利时。
9
布鲁日，比利时。
10
哈塞尔特，比利时。
11
亨克，比利时。
12
阿尔斯特，比利时。
13
比利时鲁汶。

抽象
背景：

慢性乙型肝炎B型（HBeAg）血清学转换的临床过程，结果和免疫学方面与亚洲患者的高复发率相关，但高加索队列中的数据很少。基本上在不同的种族之间
目标：

这项研究的目的是确定复发率，预测核苷酸（t）类似物停药后复发率和预后的临床结果，这些患者大多数为高加索人群，其中核苷（酸）类似物诱导的HBeAg血清学转换为慢性乙型肝炎患者。
方法：

这是一项全国性的观察性队列研究，包括来自比利时18个中心的核苷（酸）类似物诱导的HBeAg血清学转换的HBeAg阳性，单一感染的慢性乙型肝炎患者。
结果：

在中位巩固治疗8个月后停止治疗的62例患者中，30例复发。在治疗开始时（HR 1.004; P = 0.001每单位增量）和HBeAg血清学转换（HR 1.006; P = 0.013每单位增量），两种治疗开始时γ-谷氨酰转移酶水平升高与多变量Cox回归临床显着复发风险增加有关模型。治疗停止导致肝脏相关的患者严重发作。在HBeAg血清转换后继续治疗的患者中，无一例复发或发生严重的肝脏转归。
结论：

核苷（酸）类似物诱导的HBeAg血清转化后高加索慢性乙型肝炎患者的治疗停药导致一半以上可能致命结局的病人复发。这些真实世界的数据进一步支持优先继续治疗HBeAg血清学转换后的NA治疗，直至HBsAg消失。

©2018作者。由John Wiley＆Sons Ltd.出版的Alimentary Pharmacology＆Therapeutics

结论：
29498078
DOI：
10.1111 / apt.14560