乙型肝炎包膜抗原阴性患者持续功能性治愈的预测因子，以

StephenW

J Viral Hepat. 2019 Jul;26 Suppl 1:32-41. doi: 10.1111/jvh.13151.
Predictors of sustained functional cure in hepatitis B envelope antigen-negative patients achieving hepatitis B surface antigen seroclearance with interferon-alpha-based therapy.
Li MH1, Yi W2, Zhang L1, Lu Y1, Lu HH1, Shen G1, Wu SL1, Hao HX1, Gao YJ1, Chang M1, Liu RY1, Hu LP1, Cao WH1, Chen QQ1, Li JN3, Wan G4, Xie Y1.
Author information

1
    Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
2
    Department of Gynecology and Obstetrics, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
3
    Scientific Research and Education Department, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
4
    Medical Records and Statistics Department, Beijing Ditan Hospital, Capital Medical University, Beijing, China.

Abstract

Hepatitis B surface antigen (HBsAg) loss is considered a functional cure in chronic hepatitis B (CHB). However, the durability of HBsAg loss after stopping treatment remains unknown. This study aimed to assess the sustained functional cure achieved by interferon therapy in hepatitis B envelope antigen (HBeAg)-negative CHB patients. In this prospective study, 176 HBeAg-negative CHB patients with functional cure were enrolled for 12 weeks of cessation treatment, and treatment information and baseline data were collected. Hepatitis B virus (HBV) biomarkers and clinical biochemical indicators were evaluated every 3 months; liver imaging examinations were performed every 3-6 months during the 48-week follow-up. The sustained functional cure was evaluated. After the 48-week follow-up, the sustained functional cure rate was 86.63%. The cumulative rates of HBsAg reversion and HBV DNA reversion were 12.79% and 2.33%, respectively. Consolidation treatment ≥ 12 weeks after HBsAg loss achieved a significantly higher rate of sustained functional cure and significantly lower rate of HBsAg reversion than consolidation treatment < 12 weeks (76.19% vs 90.00%, P = 0.022 and 23.81% vs 9.23%, P = 0.014, respectively). Patients with hepatitis B surface antibody (HBsAb) had higher rate of sustained functional cure than patients achieving HBsAg loss but without HBsAb (89.86% vs 73.53%, P = 0.012). Consolidation treatment ≥ 12 weeks (odds ratio [OR] 16.478; 95% confidence interval [CI], 2.135-127.151; P = 0.007) and high HBsAb levels (OR 8.312; 95% CI, 1.824-37.881; P = 0.006) were independent predictors of sustained functional cure. Results suggested that 12 weeks of consolidation therapy after HBsAg clearance and elevated HBsAb levels help to improve functional cure.

© 2019 John Wiley & Sons Ltd.
KEYWORDS:

chronic hepatitis B; functional cure; hepatitis B e antigen negative; hepatitis B surface antigen loss; interferon

PMID:
    31380582
DOI:
    10.1111/jvh.13151

StephenW

J病毒肝病。 2019年7月; 26增刊1：32-41。 doi：10.1111 / jvh.13151。
乙型肝炎包膜抗原阴性患者持续功能性治愈的预测因子，以干扰素-α为基础的疗法实现乙型肝炎表面抗原血清清除。
Li MH1，Yi W2，Zhang L1，Lu Y1，Lu HH1，Shen G1，Wu SL1，Hao HX1，Gao YJ1，Chang M1，Liu RY1，Hu LP1，Cao WH1，Chen QQ1，Li JN3，Wan G4，Xie Y1 。
作者信息

1
    首都医科大学附属北京地坛医院肝病科，北京
2
    首都医科大学附属北京地坛医院妇产科，北京
3
    首都医科大学附属北京地坛医院科研教育处，北京
4
    首都医科大学附属北京地坛医院病历统计处，中国北京。

抽象

乙型肝炎表面抗原（HBsAg）丢失被认为是慢性乙型肝炎（CHB）的功能性治疗。然而，停止治疗后HBsAg消失的耐久性仍然未知。本研究旨在评估干扰素治疗乙型肝炎包膜抗原（HBeAg）阴性CHB患者的持续功能治愈。在这项前瞻性研究中，176名HBeAg阴性的CHB患者接受了功能性治疗12周的戒烟治疗，并收集了治疗信息和基线数据。每3个月评估一次乙型肝炎病毒（HBV）生物标志物和临床生化指标;在48周的随访期间，每3-6个月进行一次肝脏影像学检查。评估持续的功能性治愈。经过48周的随访，持续功能治愈率为86.63％。 HBsAg逆转和HBV DNA逆转的累积率分别为12.79％和2.33％。 HBsAg消失后≥12周的巩固治疗显着高于持续功能治愈率，HBsAg逆转率明显低于巩固治疗<12周（76.19％vs 90.00％，P = 0.022和23.81％vs 9.23％，P = 0.014 ， 分别）。乙型肝炎表面抗体（HBsAb）患者的持续功能性治愈率高于HBsAg消失但无HBsAb的患者（89.86％vs 73.53％，P = 0.012）。巩固治疗≥12周（优势比[OR] 16.478; 95％置信区间[CI]，2.135-127.151; P = 0.007）和高HBsAb水平（OR 8.312; 95％CI，1.824-37.881; P = 0.006）持续功能治愈的独立预测因子。结果表明，HBsAg清除后12周的巩固治疗和HBsAb水平升高有助于改善功能性治愈。

©2019 John Wiley＆Sons Ltd.
关键词：

慢性乙型肝炎;功能性治疗;乙型肝炎e抗原阴性;乙型肝炎表面抗原丢失;干扰素

结论：
    31380582
DOI：
    10.1111 / jvh.13151