核酸类似物治疗患者乙型肝炎核心相关抗原水平与持

StephenW

J Viral Hepat. 2019 Mar 21. doi: 10.1111/jvh.13097. [Epub ahead of print]
Relationship between hepatitis B Core related antigen levels and sustained HBeAg seroconversion in patients treated with nucleo(s)tide analogues.
Sonneveld MJ1, Van Oord GW1, van Campenhout MJ1, de Man RA1, Janssen HLA2, de Knegt RJ1, Boonstra A1, van der Eijk AA2.
Author information

1
    Departments of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
2
    Division of Gastroenterology, University Health Network, Toronto, Canada.

Abstract

HBeAg seroconversion experienced during nucleo(s)tide analogue (NUC) therapy is often not sustained. We aimed to study whether hepatitis B core related antigen (HBcrAg) levels predict sustained HBeAg seroconversion in patients treated with NUCs. We studied HBeAg-positive patients treated with NUCs for at least six months. We quantified HBcrAg at baseline and at the time of HBeAg seroconversion and studied the relationship with HBeAg seroconversion and subsequent relapse. HBcrAg was quantified at baseline in 196 patients; levels varied significantly by HBV genotype, and correlated with HBsAg, HBV DNA and HBeAg. Baseline HBcrAg levels were lower in patients who achieved HBeAg seroconversion than in those who did not; the unadjusted Hazard Ratio (HR) was 0.802 (95% CI: 0.656 - 0.980, p=0.031); this association was not sustained in multivariate analysis. HBcrAg remained detectable in all patients at the time of HBeAg seroconversion. Higher HBcrAg at the time of seroconversion was an independent predictor of relapse (adjusted HR 1.855 (95% CI: 1.099 - 3.133, p=0.021) and none of the patients with HBcrAg <4.90 log U/mL experienced relapse. Baseline HBcrAg is not an independent predictor of HBeAg seroconversion during NUC therapy. HBcrAg remains detectable in patients after HBeAg seroconversion. Patients with lower levels at the time of seroconversion have a higher probability of sustained HBeAg seroconversion. This article is protected by copyright. All rights reserved.

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

HBeAg seroconversion; entecavir; hepatitis B core related antigen; nucleo(s)tide analogues; tenofovir

PMID:
    30896057
DOI:
    10.1111/jvh.13097

StephenW

J病毒肝病。 2019年3月21日doi：10.1111 / jvh.13097。 [印刷前的电子版]
核酸类似物治疗患者乙型肝炎核心相关抗原水平与持续HBeAg血清学转换的关系。
Sonneveld MJ1，Van Oord GW1，van Campenhout MJ1，de Man RA1，Janssen HLA2，de Knegt RJ1，Boonstra A1，van der Eijk AA2。
作者信息

1
    荷兰鹿特丹Erasmus MC大学医学中心消化内科和肝病学系。
2
    加拿大多伦多大学健康网络消化内科。

抽象

在核苷酸类似物（NUC）治疗期间经历的HBeAg血清转换通常不持续。我们的目的是研究乙型肝炎核心相关抗原（HBcrAg）水平是否能预测接受NUC治疗的患者持续的HBeAg血清学转换。我们研究了用NUC治疗至少6个月的HBeAg阳性患者。我们在基线和HBeAg血清学转换时量化HBcrAg，并研究其与HBeAg血清转换和随后复发的关系。 HBcrAg在196名患者的基线量化; HBV基因型水平差异显着，与HBsAg，HBV DNA和HBeAg相关。 HBeAg血清转换患者的基线HBcrAg水平低于未患HBeAg血清转换的患者;未调整的危险比（HR）为0.802（95％CI：0.656-0.980，p = 0.031）;在多变量分析中，这种关联并不持久。在HBeAg血清学转换时，所有患者均可检测到HBcrAg。血清转换时HBcrAg较高是复发的独立预测因子（调整后的HR 1.855（95％CI：1.099  -  3.133，p = 0.021），HBcrAg <4.90 log U / mL的患者均无复发。基线HBcrAg不复发NUC治疗期间HBeAg血清学转换的独立预测因子HBeAg血清转换后HBcrAg仍然可检测到，血清学转换水平较低的患者HBeAg血清学转换的可能性较高。本文受版权保护。保留所有权利。

本文受版权保护。版权所有。
关键词：

HBeAg血清学转换;恩替卡韦;乙型肝炎核心相关抗原;核苷酸类似物;替诺福韦

结论：
    30896057
DOI：
    10.1111 / jvh.13097