接受长期核苷（酸）类似物治疗的慢性乙型肝炎患者血清乙

StephenW

Trajectories of serum hepatitis B surface antigen kinetics in patients with chronic hepatitis B receiving long‐term nucleos(t)ide analogue therapy
Wei‐Fan Hsu
Chuen‐Fei Chen
Hsueh‐Chou Lai
Wen‐Pang Su
Chia‐Hsin Lin
Po‐Heng Chuang
Sheng‐Hung Chen
Ching‐Hsiang Chen
Hung‐Wei Wang
Guan‐Tarn Huang
Cheng‐Yuan Peng
First published: 31 August 2017
https://doi.org/10.1111/liv.13564
Cited by: 1

Funding informationThis study was supported by a grant (No. DMR‐101‐011) from China Med ... More

Handling Editor: Chun‐Jen Liu

Abstract
Background & Aims

The kinetics of serum hepatitis B surface antigen (HBsAg) levels during long‐term nucleos(t)ide analogue (NA) therapy in chronic hepatitis B (CHB) patients remains unclear. We investigated the patterns of serum HBsAg kinetics and their association with therapeutic outcomes in genotype B‐ or C‐infected CHB patients receiving long‐term NA therapy.
Methods

We enrolled 329 treatment‐naive CHB patients receiving NA therapy for >5 years to analyse the kinetic patterns by using group‐based trajectory models (GBTMs).
Results

Most patients (82.4%) received entecavir therapy. The median treatment duration was 83.6 (68.5‐89.7) months. The GBTMs revealed three groups for both the hepatitis B e antigen (HBeAg)‐positive and ‐negative patients. The median annual decline in serum HBsAg levels during the first 5 years was significantly higher in Group 1 than in Groups 2 and 3 in HBeAg‐positive (0.78 vs 0.10 vs 0.10 log10IU/mL) and HBeAg‐negative (0.71 vs 0.08 vs 0.09 log10IU/mL) patients. HBsAg levels at the baseline and 12 months combined with an HBsAg decline from the baseline to 12 months of treatment predicted trajectory pattern 1 in HBeAg‐positive (sensitivity, 77.8%; specificity, 99.1%; positive predictive value [PPV], 87.5%; and negative predictive value [NPV], 98.2%) and HBeAg‐negative (sensitivity, 100%; specificity, 99.5%; PPV, 88.9%; and NPV, 100%) patients. The trajectory patterns were significantly associated with HBeAg loss in the HBeAg‐positive patients and the achievement of HBsAg <100 IU/mL or HBsAg loss in HBeAg‐positive and HBeAg‐negative patients.
Conclusions

The trajectory of serum HBsAg levels predicts HBsAg loss in CHB patients receiving long‐term NA therapy.

StephenW

接受长期核苷（酸）类似物治疗的慢性乙型肝炎患者血清乙型肝炎表面抗原动力学的轨迹
许伟凡
陈传飞
薛学周
温文庞
林嘉欣
宝恒庄
陈生红
陈清祥
王洪伟
Guan-Tarn Huang
彭成元
首次发布：2017年8月31日
https://doi.org/10.1111/liv.13564
引用者：1

资金信息本研究得到了中国医学基金会（DMR-101-011）的支持

处理编辑：刘春仁

抽象
背景和目的

慢性乙型肝炎（CHB）患者长期核苷（酸）类似物（NA）治疗期间血清乙型肝炎表面抗原（HBsAg）水平的动力学仍不清楚。我们调查了血清HBsAg动力学模式及其与接受长期NA疗法的基因型B或C感染的CHB患者的治疗结果的关联。
方法

我们招募了329名接受NA治疗的初治CHB患者5年以上，以使用基于组的轨迹模型（GBTM）分析动力学模式。
结果

大多数患者（82.4％）接受恩替卡韦治疗。中位治疗时间为83.6（68.5-89.7）个月。 GBTMs揭示了乙肝e抗原（HBeAg）阳性和阴性患者的三个组。在HBeAg阳性组中，前5年血清HBsAg水平每年中位数下降的幅度显着高于组2和组3（分别为0.78 vs 0.10 vs 0.10 log10IU / mL）和HBeAg阴性（0.71 vs 0.08 vs 0.09 log10IU / mL）患者。在基线和12个月时HBsAg水平与治疗12个月HBsAg下降联合预测HBeAg阳性（敏感度为77.8％;特异性为99.1％;阳性预测值[PPV]为87.5％;和阴性预测值[NPV]，98.2％）和HBeAg阴性（敏感性，100％;特异性，99.5％; PPV，88.9％;和NPV，100％）患者。 HBeAg阳性患者的HBeAg消失和HBeAg阳性和HBeAg阴性患者HBsAg <100 IU / mL或HBsAg消失的实现轨迹模式显着相关。
结论

血清HBsAg水平的轨迹预测了接受长期NA治疗的慢性乙型肝炎患者HBsAg消失。