EASL2019 核心突变与年度下降率之间的关联 慢性乙型肝炎患者H

StephenW

THU-215
Association between core mutations and annual decline rate of
HBVDNA and HBsAg in chronic hepatitis B patients treated with
nucleoside analogue
Takashi Honda1, Masatoshi Ishigami1, Takanori Ito1, Yoji Ishizu1,
Teiji Kuzuya1, Mitsuhiro Fujishiro1. 1Nagoya University Graduate School
of Medicine, Gastroenterology and Hepatology, Nagoya, Japan
Email: [email protected]
Background and aims: We have reported that measurement of core
I97L mutation in addition to HBVDNA and ALT levels would be useful
to predict subsequent clinical course in chronic hepatitis B (CHB)
patients. We investigated differences in annual decline rate of
HBVDNA and HBsAg between patients who treated with nucleoside
analogue therapy (NA) therapy (Group NA) and patients who were
observed in the natural history of the disease (Group N). Hepatitis B
core-related antigen (HBcrAg) may serve as useful marker for virus
replication and reflect intrahepatic cccDNA.
Method: One hundred thirty-eight CHB patients who were determined
core I97 were enrolled in this study. Median age of patients
was 42 (male/female = 67/71, Group NA/Group N = 42/96, all patients
had genotype C virus). Median observational period was 7.0 years. 1)
In Group N (n = 96) annual decline rate of HBVDNA and HBsAg were
compared according to presence of core I97L mutation. 2) Among
Group NA (n = 42) annual decline rate of HBVDNA and HBsAg were
compared according to presence of core I97L mutation before NA
therapy. Moreover, HBcrAg at final visit was also compared according
to presence of core I97L mutation.
Results: 1) In Group N annual decline rate of HBVDNA in patients
with I97L was significantly higher than that in patients with I97
wild-type (0.23 log copies/ml/year, 0.05 log copies/ml/year, respectively,
p = 0.036). On the other hand, annual decline rate of HBsAg inpatients with I97L was significantly higher than that in patients with
I97 wild (0.10 IU/ml/year, 0.05 IU/ml/year, respectively, p = 0.003).
Furthermore, the rate of HBsAg loss in patients with I97L was
significantly higher than that in the patients with I97 wild (24.3% vs.
3.6%, respectively, p = 0.002). 2) Among Group NA there was no
significant difference in annual decline rate of HBVDNA and HBsAg.
However, HBcrAg of the patient with I97L was significantly lower
than that of the patients with I97I/Fwild (3.0 logU/ml vs. 3.7 logU/ml,
respectively).
Conclusion: In CHB patients, patients with I97L had significantly
higher annual decline rate of HBVDNA and HBsAg. Patients with I97L
before NA treatment showed significantly lower HBcrAg at final visit.
These results suggest HBcrAg levels would be low in patients who
have I97L mutation before NA therapy.

StephenW

THU-215
核心突变与年度下降率之间的关联
慢性乙型肝炎患者HBVDNA和HBsAg治疗
核苷类似物
Takashi Honda1，Masatoshi Ishigami1，Takanori Ito1，Yoji Ishizu1，
Teiji Kuzuya1，Mitsuhiro Fujishiro1。 1名古屋大学研究生院
日本名古屋医学，消化内科和肝病学杂志
电子邮件：[email protected]
背景和目的：我们已经报道了测量核心
除了HBVDNA和ALT水平之外，I97L突变也是有用的
预测慢性乙型肝炎（CHB）的后续临床过程
耐心。我们调查了年度下降率的差异
用核苷治疗的患者之间的HBVDNA和HBsAg
模拟疗法（NA）疗法（NA组）和患者
观察到该疾病的自然史（N组）。乙型肝炎
核心相关抗原（HBcrAg）可以作为病毒的有用标记
复制并反映肝内cccDNA。
方法：确定了138名CHB患者
核心I97参加了这项研究。患者的中位年龄
是42（男/女= 67/71，NA组/ N组= 42/96，所有患者
有基因型C病毒）。中位观察期为7.0岁。 1）
在N组（n = 96）中，HBVDNA和HBsAg的年降低率为
根据核心I97L突变的存在进行比较。其中
组NA（n = 42）HBVDNA和HBsAg的年降幅均为
根据NA之前核心I97L突变的存在进行比较
治疗。此外，最终访问的HBcrAg也进行了比较
存在核心I97L突变。
结果：1）N组患者HBVDNA年降低率
I97L明显高于I97患者
野生型（0.23 log拷贝/ ml /年，0.05 log拷贝/ ml /年，分别为
p = 0.036）。另一方面，I97L住院患者HBsAg的年降幅明显高于患者
I97野生（0.10IU / ml /年，0.05IU / ml /年，p = 0.003）。
此外，I97L患者的HBsAg消失率为
显着高于I97野生患者（24.3％vs.
分别为3.6％，p = 0.002）。 2）在NA组中没有
HBVDNA和HBsAg年降幅明显不同。
然而，I97L患者的HBcrAg显着降低
比I97I / Fwild患者（3.0 logU / ml vs. 3.7 logU / ml，
分别）。
结论：在CHB患者中，I97L患者显着
HBVDNA和HBsAg的年降幅较高。 I97L患者
在NA治疗前，最终就诊时HBcrAg显着降低。
这些结果表明患者的HBcrAg水平较低
NA治疗前有I97L突变。