持续的治疗后病毒控制与具有核仁（t）ide类似物诱导的HBeAg

StephenW

J Viral Hepat. 2019 Feb 23. doi: 10.1111/jvh.13084. [Epub ahead of print]
Sustained off-treatment viral control is associated with high Hepatitis B Surface Antigen seroclearance rates in Caucasian patients with Nucleos(t)ide Analogue induced HBeAg seroconversion.
Van Hees S1,2, Chi H3, Hansen B3,4, Bourgeois S1,5, Van Vlierberghe H6, Sersté T7, Francque S1,2, Wong D4, Sprengers D8, Moreno C9, Nevens F10, Janssen HLA3,4, Vanwolleghem T1,2,3.
Author information

1
    Department of Gastroenterology and Hepatology, Antwerp University Hospital, Antwerp, Belgium.
2
    Laboratory of Experimental Medicine and Pediatrics, Antwerp University, Antwerp, Belgium.
3
    Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands.
4
    Toronto Centre of Liver Disease, University Health Network, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
5
    Department of Gastroenterology and Hepatology, ZNA Stuivenberg, Antwerp, Belgium.
6
    Department of Gastroenterology and Hepatology, Ghent University Hospital, Ghent, Belgium.
7
    Department of Gastroenterology and Hepatology, Saint-Pierre University Hospital, Brussels, Belgium.
8
    Department of Gastroenterology and Hepatology, GZA Antwerp, Antwerp, Belgium.
9
    Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
10
    Department of Hepatology, University Hospitals KULeuven, Leuven, Belgium.

Abstract

Nucleos(t)ide Analogue withdrawal has been described to result in significant Hepatitis B surface antigen (HBsAg) loss rates in patients with long-term viral suppression and negative HBeAg at the start of treatment. In these patients off-treatment HBsAg loss is often preceded by viral rebound with concomitant Alanine Aminotransferase flares. In the present study, we investigated off-treatment HBsAg loss in a multicentric, international observational cohort of patients with Nucleos(t)ide Analogue induced HBeAg seroconversion. Ninety eight mono-infected, predominantly male (74.4%) chronic hepatitis B patients of mixed ethnicity (43.9% Asians, 49.0% Caucasians) who stopped treatment at a median of 11.4 (6.1-18.0) months after HBeAg seroconversion were included. A total of 16 patients experienced Hepatitis B surface Antigen loss during a median follow-up of 42.8 (22.7-83.2) months after treatment cessation: 14 off-treatment and 2 after retreatment initiation with subsequent long-term viral suppression. All patients with off-treatment HBsAg loss showed persistently low ALT (<1.5xULN) and HBV DNA (<2000 IU/mL) levels after HBeAg seroconversion. Persistent viral control was associated with significantly higher annual HBsAg seroclearance rates (8.4%) than relapse with (1.5%; p=0.008) or without (0.0%; p=0.009) subsequent retreatment. In addition, Caucasian patients with sustained off-treatment viral control had >6-fold higher annual HBsAg loss rates compared to non-Caucasian patients (14.8% vs 2.3% respectively; p=0.004).Persistent viral control after treatment cessation following NA induced HBeAg seroconversion was associated with high HBsAg loss rates in Caucasian patients.

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KEYWORDS:

RRID ; Ethnicity; Hepatitis B Virus; Hepatitis B surface Antigen; SCR_002865; Sustained Virologic Response; Treatment cessation

PMID:
    30801868
DOI:
    10.1111/jvh.13084

StephenW

J病毒肝病。 2019年2月23日。土井：10.1111 / jvh.13084。 [印刷前的电子版]
持续的治疗后病毒控制与具有核仁（t）ide类似物诱导的HBeAg血清转化的高加索人患者中的高乙型肝炎表面抗原血清清除率相关。
Van Hees S1,2，Chi H3，Hansen B3,4，Bourgeois S1,5，Van Vlierberghe H6，SerstéT7，Francque S1,2，Wong D4，Sprengers D8，Moreno C9，Nevens F10，Janssen HLA3,4，Vanwolleghem T1 ，2,3。
作者信息

1
    比利时安特卫普安特卫普大学医院消化内科和肝病学系。
2
    比利时安特卫普安特卫普大学实验医学与儿科实验室。
3
    荷兰鹿特丹鹿特丹伊拉斯谟MC大学医学中心胃肠病学和肝病学系。
4
    多伦多大学健康网络，多伦多综合医院，多伦多大学，多伦多，安大略省，加拿大多伦多肝病中心。
五
    比利时安特卫普ZNA Stuivenberg胃肠病学和肝病学系。
6
    比利时根特根特大学医院消化内科和肝病学系。
7
    比利时布鲁塞尔圣皮埃尔大学医院消化内科和肝病学系。
8
    比利时安特卫普GZA安特卫普胃肠病学和肝病学系。
9
    布鲁塞尔自由大学消化内科，肝胰腺和消化肿瘤学系，CUBHôpitalErasme，比利时布鲁塞尔。
10
    比利时鲁汶大学医院肝病科KULeuven。

抽象

Nucleos（t）ide类似物撤除已被描述为在治疗开始时长期病毒抑制和HBeAg阴性的患者中导致显着的乙型肝炎表面抗原（HBsAg）丢失率。在这些患者中，治疗后HBsAg的丢失常常伴随着病毒反弹，并伴有丙氨酸氨基转移酶突发。在本研究中，我们研究了Nucleos（t）ide类似物诱导的HBeAg血清转换患者的多中心国际观察队列中的治疗后HBsAg消失。在HBeAg血清学转换后中位数为11.4（6.1-18.0）的中位数治疗中，有98名单一感染，主要为男性（74.4％）的混合族慢性乙型肝炎患者（43.9％亚洲人，49.0％白种人）停止治疗。在治疗停止后42.8（22.7-83.2）个月的中位随访期间，总共16名患者经历了乙型肝炎表面抗原丢失：14次治疗后和2次治疗后再次治疗以及随后的长期病毒抑制。所有HBsAg治疗失败的患者在HBeAg血清学转换后均表现出持续低的ALT（<1.5xULN）和HBV DNA（<2000 IU / mL）水平。持续病毒控制与年复一年的HBsAg血清清除率（8.4％）显着高于随后再治疗（1.5％; p = 0.008）或无复发（0.0％; p = 0.009）的复发。此外，与非白种人患者相比，持续治疗后病毒控制的白种人患者的年HBsAg丢失率高出6倍（分别为14.8％和2.3％; p = 0.004）.Na诱导治疗后持续的病毒控制HBeAg血清学转换与白种人患者的高HBsAg丢失率相关。

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关键词：

RRID;种族;乙型肝炎病毒;乙型肝炎表面抗原; SCR_002865;持续的病毒学反应;治疗停止

结论：
    30801868
DOI：
    10.1111 / jvh.13084