恩替卡韦或替诺福韦治疗中断后，慢性乙型肝炎患者再治疗

StephenW

PLoS One. 2019 Oct 4;14(10):e0222221. doi: 10.1371/journal.pone.0222221. eCollection 2019.
Incidence and predictors of retreatment in chronic hepatitis B patients after discontinuation of entecavir or tenofovir treatment.
Ma TL1, Hu TH1, Hung CH1, Wang JH1, Lu SN1, Chen CH1.
Author information

1
    Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Abstract
BACKGROUND:

This study investigated the incidence and predictors of retreatment after discontinuation of either entecavir (ETV) or tenofovir disoproxil fumarate (TDF) treatment in Taiwan.
METHODS:

A total of 535 non-cirrhotic chronic hepatitis B (CHB) patients undergoing either ETV (n = 358) or TDF (n = 177) treatment were enrolled. Patients were followed for at least 12 months after stopping ETV or TDF treatment. Most patients (86.3%) fulfilled the retreatment criteria of Taiwan's National Health Plan.
RESULTS:

The 5-year cumulative rates of clinical relapse and retreatment were 52.1% and 47%, respectively, in 160 hepatitis B e antigen (HBeAg)-positive patients, and were 62% and 54.8%, respectively, in 375 HBeAg-negative patients. The median duration from the end of treatment until clinical relapse and retreatment was 40 and 57 weeks, respectively, for all patients. Multivariate Cox regression analysis revealed that discontinuing TDF treatment, old age, male gender, and higher baseline HBsAg levels were independent factors of retreatment in HBeAg-positive patients; old age, HBV genotype B, and higher baseline and end-of-treatment HBsAg levels were independent factors in HBeAg-negative patients. A total of 18.8% of retreated patients satisfied the retreatment criteria of hepatic decompensation according to Taiwan's National Health Plan. Of the 64 patients who had clinical relapse without retreatment, 17 achieved sustained virological remission and 26 did not experience clinical relapse until their last visit after clinical relapse. Four patients developed HBsAg loss.
CONCLUSIONS:

The 5-year retreatment rate was about 50% in HBeAg-positive and HBeAg-negative patients. Discontinuing TDF treatment was an independent factor of retreatment in HBeAg-positive patients.

PMID:
    31584951
DOI:
    10.1371/journal.pone.0222221

StephenW

PLoS一。 2019十月4; 14（10）：e0222221。 doi：10.1371 / journal.pone.0222221。 eCollection 2019。
恩替卡韦或替诺福韦治疗中断后，慢性乙型肝炎患者再治疗的发生率和预测因素。
Ma TL1，Hu TH1，Hung CH1，Wang JH1，Lu SN1，Chen CH1。
作者信息

1个
    台湾高雄市长庚纪念医院和长庚大学医学院内科肝消化肠内科。

抽象
背景：

这项研究调查了台湾停用恩替卡韦（ETV）或替诺福韦富马酸替诺福韦（TDF）治疗后再治疗的发生率和预测因素。
方法：

共有535名接受ETV（n = 358）或TDF（n = 177）治疗的非肝硬化慢性乙型肝炎（CHB）患者入组。停止ETV或TDF治疗后，对患者进行了至少12个月的随访。大多数患者（86.3％）符合台湾《国民健康计划》的再治疗标准。
结果：

160例乙型肝炎e抗原（HBeAg）阳性患者的5年临床复发和再治疗累积率分别为52.1％和47％，而375例HBeAg阴性患者分别为62％和54.8％。所有患者从治疗结束到临床复发和再治疗的中位持续时间分别为40周和57周。多变量Cox回归分析显示，在HBeAg阳性患者中，停止TDF治疗，年龄，男性，较高的HBsAg基线水平是重新治疗的独立因素。年龄，HBV基因型B，基线和治疗结束后HBsAg水平较高是HBeAg阴性患者的独立因素。根据台湾的《国民健康计划》，总共有18.8％的复发患者达到了肝脏代偿失调的复发标准。在未经治疗的临床复发的64例患者中，有17例达到了持续的病毒学缓解，而26例直到临床复发后才进行临床复发。四例患者出现HBsAg丢失。
结论：

HBeAg阳性和HBeAg阴性患者的5年再治疗率约为50％。终止TDF治疗是HBeAg阳性患者再次治疗的独立因素。

PMID：
    31584951
DOI：
    10.1371 / journal.pone.0222221