非肝硬化HBeAg阴性慢性乙型肝炎停用有效口服抗病毒治疗后HBs

StephenW

J Viral Hepat. 2019 Sep 28. doi: 10.1111/jvh.13211. [Epub ahead of print]
Predictors of HBsAg loss, relapse and retreatment after discontinuation of effective oral antiviral therapy in non-cirrhotic HBeAg-negative chronic hepatitis B.
Papatheodoridi M1, Hadziyannis E2, Berby F3, Zachou K4, Testoni B3, Rigopoulou E4, Gatselis NK4, Lyberopoulou A4, Vlachogiannakos I1, Manolakopoulos S1,2, Dalekos GN4, Zoulim F3, Papatheodoridis GV1.
Author information

1
    Department of Gastroenterology, Medical School of National, Kapodistrian University of Athens, General Hospital of Athens "Laiko", Athens, Greece.
2
    Department of Internal Medicine, Medical School of National, Kapodistrian University of Athens, General Hospital of Athens "Hippokratio", Athens, Greece.
3
    INSERM U1052 - Cancer Research Center of Lyon (CRCL), 69008, Lyon, France.
4
    Department of Medicine and Research Laboratory of Internal Medicine, Thessaly University Medical School, Larissa, Greece.

Abstract

Reliable predictors of outcomes after treatment discontinuation in HBeAg-negative chronic hepatitis B (CHB) patients have not been established. We investigated the role of hepatitis B surface antigen (HBsAg), interferon inducible protein-10 (IP10) and hepatitis B core related antigen (HBcrAg) serum levels as predictors of HBsAg loss, relapse and retreatment in non-cirrhotic HBeAg-negative CHB patients who discontinued long-term antiviral therapy. All HBsAg-positive (n=57) patients of the prospective DARING-B study were included and followed monthly for 3 months, every 2/3 months until month-12 and every 3/6 months thereafter. HBsAg, IP10 and HBcrAg levels were measured by enzyme immunoassays and SCALE-B score was calculated. Twelve patients achieved HBsAg loss before retreatment with 18-month cumulative incidence of 25%. Independent predictors of HBsAg loss were baseline HBsAg and month-1 IP10 levels. Of 10 patients with baseline HBsAg≤100 IU/mL, 70% cleared HBsAg and 10% required retreatment. Of 23 patients with baseline HBsAg>1000 IU/mL, 4% cleared HBsAg and 43% required retreatment. Of 24 patients with intermediate baseline HBsAg (100-1000 IU/mL), 17% cleared HBsAg and 21% required retreatment; in this subgroup, month-1 IP10 was significantly associated with HBsAg loss, which occurred in 30% and 7% of cases with IP10 >150 and ≤150 pg/mL, respectively. Baseline HBcrAg was undetectable in all patients who cleared HBsAg and was associated with retreatment. SCALE-B was associated with HBsAg loss but not with relapse or retreatment. In conclusion, HBsAg, IP10 and HBcrAg serum levels can be useful for the decisions and management of treatment discontinuation in non-cirrhotic Caucasian patients with HBeAg-negative CHB.

© 2019 John Wiley & Sons Ltd.
KEYWORDS:

entecavir; hepatitis B core related antigen; hepatitis B surface antigen; interferon-inducible protein 10; tenofovir

PMID:
    31562748
DOI:
    10.1111/jvh.13211

StephenW

J病毒性肝炎。 2019年9月28日。doi：10.1111 / jvh.13211。 [Epub提前发布]
非肝硬化HBeAg阴性慢性乙型肝炎停用有效口服抗病毒治疗后HBsAg丢失，复发和再治疗的预测指标。
Papatheodoridi M1，Hadziyannis E2，Berby F3，Zachou K4，Testoni B3，Rigopoulou E4，Gatselis NK4，Lyberopoulou A4，Vlachogiannakos I1，Manolakopoulos S1、2，Dalekos GN4，Zoulim F3，Papatheodoridis G.
作者信息

1
雅典卡普迪斯安大学国立医学院胃肠病学系，雅典“ Laiko”总医院，希腊雅典。
2
雅典卡波迪斯安大学国立医学院内科，希腊雅典雅典“ Hippokratio”总医院。
3
INSERM U1052-里昂癌症研究中心（CRCL），69008，法国里昂。
4
色萨利大学医学院医学系和内科研究实验室，希腊拉里萨。

抽象

尚未确定HBeAg阴性慢性乙型肝炎（CHB）患者停药后结局的可靠预测指标。我们调查了乙型肝炎表面抗原（HBsAg），干扰素诱导蛋白10（IP10）和乙型肝炎核心相关抗原（HBcrAg）血清水平在非肝硬化性HBeAg阴性CHB患者中预测HBsAg丢失，复发和再治疗的作用。谁终止了长期的抗病毒治疗。纳入所有前瞻性DARING-B研究的HBsAg阳性（n = 57）患者，并且每月3个月，每2/3个月直到12个月以及之后每3/6个月。通过酶联免疫法测定HBsAg，IP10和HBcrAg水平，并计算SCALE-B评分。 12例患者在重新治疗前HBsAg丢失，18个月累积发生率为25％。 HBsAg丢失的独立预测因素是基线HBsAg和第1个月IP10水平。在基线HBsAg≤100 IU / mL的10例患者中，70％清除HBsAg且需要重新治疗的10％在23基线HBsAg> 1000 IU / mL的患者中，清除HBsAg的4％和需要再治疗的43％。在24名基线中度HBsAg（100-1000 IU / mL）患者中，有17％清除了HBsAg，而21％需要再次治疗。在该亚组中，第1个月IP10与HBsAg丢失显着相关，分别在IP10> 150和≤150pg / mL的病例中分别发生30％和7％。在所有清除HBsAg的患者中均未检测到基线HBcrAg，且与HBsAg相关联，IP10和HBcrAg血清水平可用于非肝硬化的高HBeAg阴性CHB患者的决策和管理中止治疗。

©2019 John Wiley＆Sons Ltd.
关键词：

Endecuvir;乙肝核心相关抗原；乙型肝炎表面抗原；干扰素诱导蛋白10；替诺福韦

结论：
31562748
DOI：
10.1111 / jvh.13211