停止使用核苷（t）ide类似物治疗慢性乙型肝炎患者后，乙型

StephenW

Eur J Gastroenterol Hepatol. 2019 Feb;31(2):267-271. doi: 10.1097/MEG.0000000000001289.
Hepatitis B surface antigen loss after discontinuing nucleos(t)ide analogue for treatment of chronic hepatitis B patients is persistent in White patients.
Suárez E1, Buti M2, Rodríguez M3, Prieto M4, Pascasio-Acevedo JM5, Casanovas T6, Crespo J7, Tapiador JAR8, Gómez-Rodríguez R9, Figueruela B1, Diago M10, Morillas RM11, Zozaya JM12, Calleja JL13, Casado M14, Molina E15, Fuentes J16, Simón MA17.
Author information
Abstract
OBJECTIVE:

The objective of this study was to determine the long-term clinical outcome and persistence of hepatitis B surface antigen (HBsAg) loss after discontinuation of treatment.
BACKGROUND:

The prognosis of patients with chronic hepatitis B (CHB) treated with nucleos(t)ide analogues (NAs) who discontinue treatment after loss of HBsAg remains largely unknown, particularly in White patients.
PATIENTS AND METHODS:

We analysed a cohort of patients with CHB who discontinued NA treatment after loss of HBsAg. A total of 69 patients with hepatitis-B-e antigen-positive or hepatitis-B-e antigen-negative CHB with undetectable HBsAg during NA treatment were included after discontinuation of treatment, and followed up for a median period of 37.8 months (interquartile range: 23.8-54.6 months).
RESULTS:

At the end of follow-up, none of the patients showed spontaneous reappearance of HBsAg and only one patient had detectable hepatitis B virus DNA (22 IU/ml). Another patient negative for HBsAg and anti-HBs developed hepatitis B virus reactivation without elevated transaminases after treatment with corticosteroids and vincristine for dendritic cell neoplasm, 38 months after withdrawal of the antiviral treatment. Regarding clinical outcome, a patient with cirrhosis developed hepatocellular carcinoma, 6.6 years after discontinuing treatment. None of the patients had hepatic decompensation or underwent liver transplantation.
CONCLUSION:

HBsAg clearance after discontinuing NAs in patients with CHB is persistent and associated with good prognosis. The risk for developing hepatocellular carcinoma persists among patients with cirrhosis.

PMID:
    30576297
DOI:
    10.1097/MEG.0000000000001289

StephenW

Eur J Gastroenterol Hepatol。 2019年2月; 31（2）：267-271。 doi：10.1097 / MEG.0000000000001289。
停止使用核苷（t）ide类似物治疗慢性乙型肝炎患者后，乙型肝炎表面抗原丢失在白人患者中持续存在。
SuárezE1，Buti M2，RodríguezM3，Prieto M4，Pascasio-Acevedo JM5，Casanovas T6，Crespo J7，Tapiador JAR8，Gómez-RodríguezR9，Figueruela B1，Diago M10，Morillas RM11，Zozaya JM12，Calleja JL13，Casado M14，Molina E15，Fuentes J16，SimónMA17。
作者信息
抽象
目的：

本研究的目的是确定停止治疗后乙型肝炎表面抗原（HBsAg）丢失的长期临床结果和持续性。
背景：

用HBsAg丢失后停止治疗的核苷（酸）类似物（NAs）治疗的慢性乙型肝炎（CHB）患者的预后仍然很大程度上未知，特别是在白人患者中。
患者和方法：

我们分析了一组患有CHB的患者，他们在HBsAg丧失后停止了NA治疗。在停止治疗期间共纳入69例肝炎-Be抗原阳性或肝炎-Be抗原阴性CHB并且在NA治疗期间检测不到HBsAg，并且随访中位时间为37.8个月（四分位数间距：23.8-54.6）个月）。
结果：

在随访结束时，没有患者表现出HBsAg的自发再现，并且只有一名患者具有可检测的乙型肝炎病毒DNA（22IU / ml）。在停用抗病毒治疗38个月后，另一名HBsAg和抗HBs阴性的患者在用皮质类固醇和长春新碱治疗树突状细胞肿瘤后，转换酶升高而乙型肝炎病毒再次激活。关于临床结果，肝硬化患者在停止治疗后6。6年发展为肝细胞癌。没有患者出现肝功能失代偿或肝移植。
结论：

在CHB患者中停用NAs后的HBsAg清除是持久的并且与良好的预后相关。在患有肝硬化的患者中，患肝细胞癌的风险仍然存在。

结论：
    30576297
DOI：
    10.1097 / MEG.0000000000001289