慢性乙型肝炎患者对核苷（酸）类似物的10年疗效反应：与治

StephenW

J Dig Dis. 2018 Aug 11. doi: 10.1111/1751-2980.12654. [Epub ahead of print]
Ten-year off-treatment responses to nucleos(t)ide analogues in chronic hepatitis B patients: varying with pretreatment HBeAg status.
Liu F1, Liu ZR1,2, Li T1, Liu YD3, Zhang M2, Xue Y1, Zhang LX1, Ye Q1, Fan XP4, Wang L1.
Author information

1
    Department of Infectious Disease and Hepatology, the Second Hospital of Shandong University.
2
    Jinan Infectious Disease Hospital, Shandong University School of Medicine.
3
    Yantai Infectious Disease Hospital.
4
    Qingdao Infectious Disease Hospital.

Abstract
AIM:

To evaluate the long-term durability of nucleos(t)ide analogues (NAs)' efficacy and to explore related factors for virological relapse in a younger cohort of chronic hepatitis B (CHB).
METHODS:

CHB patients who fulfilled cessation criteria to discontinue NAs therapy (in accordance with guidelines by APASL and AASLD) were included in the study since December 2001. Virological relapse was defined as serum HBV DNA>104 copies/mL twice at least 2 weeks apart.
RESULTS:

A total of 223 CHB patients were enrolled at the time of NAs treatment was discontinued. The cumulative relapse rate (CRR) in HBeAg-positive patients (20.3%, 23.4%, 27.9% and 30.9% at year 1, 3, 5 and 10) was statistically lower than that in HBeAg-negative patients (44.7%, 52.5%, 57.4% and 62.3% at year 1, 3, 5 and 10, P<0.001). In the HBeAg-positive group, Cox regression revealed that age at cessation (HR 1.081, P<0.001), consolidation treatment (HR 0.947, P=0.007), and time to HBeAg seroconversion (HR 0.938, P=0.015) were predictors for relapse. In the HBeAg-negative group, Cox regression indicated that age (HR 1.029, P=0.026) and time to HBVDNA negativity (HR 1.257, P=0.001) were predictors for relapse.
CONCLUSIONS:

The off-treatment responses to NAs do differ in CHB patients with different pretreatment HBeAg status. NAs withdrawal is generally safe and feasible in young CHB patients. Longer consolidation periods should be preferred in HBeAg-positive patients to achieve better durability. Finite NAs treatment results in poor durability in HBeAg-negative CHB patients. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.
KEYWORDS:

Hepatitis B e antigen; Hepatitis B, Chronic; Nucleos(t)ide analogues; Recurrence

PMID:
    30098114
DOI:
    10.1111/1751-2980.12654

StephenW

J Dig Dis。 2018年8月11日doi：10.1111 / 1751-2980.12654。 [提前打印]
慢性乙型肝炎患者对核苷（酸）类似物的10年疗效反应：与治疗前HBeAg状态不同。
Liu F1，Liu ZR1,2，Li T1，Liu YD3，Zhang M2，Xue Y1，Zhang LX1，Ye Q1，Fan XP4，Wang L1。
作者信息

1
    山东大学第二医院传染病与肝病科。
2
    山东大学医学院济南市传染病医院。
3
    烟台传染病医院。
4
    青岛市传染病医院。

抽象
目标：

评估核苷（t）ide类似物（NAs）的长期耐久性，并探讨较年轻的慢性乙型肝炎（CHB）队列中病毒学复发的相关因素。
方法：

自2001年12月以来，符合戒烟标准终止NAs治疗的CHB患者（根据APASL和AASLD的指南）被纳入该研究。病毒复发被定义为血清HBV DNA> 104拷贝/ mL，间隔至少2周两次。
结果：

在停止NAs治疗时共招募了223名CHB患者。 HBeAg阳性患者的累积复发率（CRR）（1年，3年，5年和10年分别为20.3％，23.4％，27.9％和30.9％）在统计学上低于HBeAg阴性患者（44.7％，52.5％） ，第1,3,5和10年分别为57.4％和62.3％，P <0.001）。在HBeAg阳性组中，Cox回归显示停止年龄（HR 1.081，P <0.001），巩固治疗（HR 0.947，P = 0.007）和HBeAg血清转换时间（HR 0.938，P = 0.015）是预测因素复发。在HBeAg阴性组中，Cox回归表明年龄（HR 1.029，P = 0.026）和HBVDNA阴性时间（HR 1.257，P = 0.001）是复发的预测因子。
结论：

对于具有不同治疗前HBeAg状态的CHB患者，对NAs的治疗反应确实不同。在年轻的CHB患者中，NAs戒断通常是安全可行的。 HBeAg阳性患者应优先考虑更长的巩固期，以获得更好的耐久性。有限的NAs治疗导致HBeAg阴性CHB患者的耐久性差。本文受版权保护。版权所有。

本文受版权保护。版权所有。
关键词：

乙型肝炎e抗原;乙型肝炎，慢性;核苷（酸）类似物;循环

结论：
    30098114
DOI：
    10.1111 / 1751-2980.12654