Virginia Schad, PharmD
November 12, 2018
Low Rates of HBsAg Seroclearance in Chronic HBV Infection
Low rates of HBsAg seroclearance were found in untreated and treated patients with chronic hepatitis B infection. Low rates of HBsAg seroclearance were found in untreated and treated patients with chronic hepatitis B infection.
Patients with chronic hepatitis B virus (HBV) infection should receive lifelong treatment because of the very low incidence rates of hepatitis B surface antigen (HBsAg) seroclearance regardless of treatment, according to a systematic review and meta-analysis published in Gastroenterology.1
Patients who have chronic HBV infection are at risk of developing cirrhosis and hepatocellular carcinoma, and although curative therapies are not available for chronic HBV, the therapeutic goal is to achieve functional cure.2
Reported annual HBsAg seroclearance rates are currently low with available treatments; therefore, researchers analyzed 34 published studies with 42,588 patients and 303,754 person-years of follow-up to provide a more precise estimate of HBsAg seroprevalence rates among subgroups and populations.1,2 They found that the pooled annual rate of HBsAg seroclearance was 1.02%, and cumulative incidence rates were 4.03% at 5 years, 8.16% at 10 years, and 17.99% at 15 years.
Seroclearance occurred mainly in patients with less active disease, with a higher proportion of patients achieving seroclearance who were negative for hepatitis B e antigen (HBeAg) at baseline than patients who were HBeAg positive at baseline (1.33% vs 0.40%; P <.01).
Patients with low levels of HBV DNA and low quantitative HBsAg levels at baseline were also more likely to achieve HBsAg seroclearance than patients with higher levels of HBV DNA and HBsAg (P <.01). HBV genotype or treatment history with available oral antiviral therapy did not seem to have a substantial effect on HBsAg seroclearance.
"In conclusion, in this systematic review and meta-analysis, we determined that the incident rate of HBsAg seroclearance was a rare event such that by year 15 after study entry, less than 20% of patients had cleared HBsAg," stated the authors.1 Thus, "patients with chronic HBV infection should therefore be counseled on the need for lifelong treatment, and curative therapies are needed."作者: StephenW 时间: 2018-11-13 15:16
Virginia Schad,PharmD
2018年11月12日
慢性HBV感染中HBsAg血清清除率低
Patients with advanced fibrosis or cirrhosis prior to antiviral treatment will have decreased but persistent risk of hepatocellular carcinoma following cure of hepatitis C.
在抗病毒治疗之前患有晚期纤维化或肝硬化的患者在治愈丙型肝炎后肝细胞癌的风险会降低但持续存在。作者: 纠结哥哥 时间: 2018-11-24 20:50
2015年4月
Risk of hepatocellular carcinoma in chronic hepatitis B: Assessment and modification with current antiviral therapy
Using only studies reporting comparative data with vs. without NA treatment, all of which were from Asia, treatment with a current NA resulted in a significant reduction of HCC risk by ∼30% in cirrhotic patients, and by ∼80% in non-cirrhotic patients.
仅使用报告比较数据与非NA治疗的比较数据,所有这些都来自亚洲,当前NA治疗导致肝硬化患者HCC风险显着降低~30%,非肝硬化患者降低~80% 。作者: 纠结哥哥 时间: 2018-11-25 08:06