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463
THE ROLE OF SOLUBLE PROGRAMMED CELL DEATH PROTEIN
1 ON HBV RELAPSE AND HBsAg LOSS AFTER CESSATION
OF ENTECAVIR THERAPY IN HBEAG-POSITIVE AND HBEAGNEGATIVE
NON-CIRRHOTIC PATIENTS
Chien Hung Chen1, Jing-Houng Wang2, Tsung-Hui Hu3,
Chao-Hung Hung4 and Sheng-Nan LU4, (1)Division of
Hepatogastroenterology, Department of Internal Medicine,
Kaohsiung Chang Gung Memorial Hospital, (2)Division of
Hepatogastroenterology, Department of Internal Medicine,
Kaohsiung Chang Gung Memorial Hospital, 123 Ta Pei Road,
Kaohsiung, Taiwan,, (3)Division of Hepato-Gastroenterology,
Department of Internal Medicine, Kaohsiung Chang
Gung Memorial Hospital and Chang Gung University
College of Medicine, Kaohsiung, Taiwan, (4)Division of
Hepatogastroenterology, Department of Internal Medicine,
Chiayi Chang Gung Memorial Hospital
Background: Recent study showed serum soluble
programmed cell death protein 1 (sPD-1) is an important
immune-related marker for assessment of HBV activity.
However, it remains unclear whether serum sPD-1 levels
could predict HBV relapse or HBsAg loss after cessation of
nucleos(t)ide analogues (NAs) therapy The aims of this study
are to investigate (1) changes of serum sPD-1 levels during
and post-NA therapy. (2) role of sPD-1 on HBV relapse and
HBsAg loss after cessation of entecavir therapy Methods:
A total of 117 HBeAg-positive and 277 HBeAg-negative noncirrhotic
patients who had stopped entecavir treatment for at
least 12 months were recruited sPD-1 levels were check at
baseline, end of treatment and post-treatment 6 months All
patients fulfilled the stopping criteria proposed by of the Asian
Pacific Association for the Study of the Liver (APASL) 2012
guideline Results: The mean of sPD-1 levels at baseline, end
of treatment and post-treatment 6 months were 5 65±0 86,
4 69±0 69, 4 74±0 74 log pg/mL, respectively, in HBeAgpositive
patients and were 4 79±0 87, 4 15±0 79, 4 16±0 81
log pg/mL, respectively, in HBeAg-negative patients HBeAgpositive
patients had higher sPD-1 decline levels from end
of treatment to baseline than HBeAg-negative patients
(P=0 002) Patients without virological relapse had a higher
sPD-1 decline levels from end of treatment to post-treatment 6
months than those with virological relapse in HBeAg-positive
(0 03±0 24 vs -0 13±0 47 log pg/mL, P=0 023) and HBeAgnegative
patients (0 11±0 40 vs -0 07±0 42 log pg/mL,
P=0 001) The 6-year cumulative rates of virological relapse,
clinical relapse, and HBsAg loss were 58 5%, 49 8%, and
12 5%, respectively, in HBeAg-positive patients, and were
71 6%, 57 1%, and 31 6%, respectively, in HBeAg-negative
patients sPD-1 levels at post-treatment 6 months was an
independent factor of virological relapse in HBeAg-positive
and HBeAg-negative patients End-of-treatment HBsAg levels
was an independent factor of HBsAg loss in both groups. We
utilized a sPD-1 at post-treatment 6 months of 3000 pg/mL
and end-of-treatment HBsAg of 150 IU/mL as the optimal
values for predicting HBV relapse and HBsAg loss in HBeAgnegative
patients Of the patients who achieved sPD-1<3000
and ≥ 3000 pg/mL, the 5-year cumulative rates of virological
and clinical relapse, and HBsAg loss were 36 3% vs 82 4%,
24 7% vs 66 7%, and 52 1% vs 11 1%, respectively (all P <
0 001) Patients who achieved HBsAg<150 IU/mL and sPD-
1<3000 pg/mL, the 5-year cumulative rates of virological and
clinical relapse, and HBsAg loss were 27 6% , 21 6%, and
53 8%, respectively Conclusion: sPD-1 decline levels during
entecavir therapy was higher in HBeAg-positive patients
compared with HBeAg-negative patients sPD-1 levels at
post-treatment 6 months was a useful marker to predict HBV
relapse and HBsAg loss after discontinuation of entecavir
treatment.
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发表于 2019-10-26 16:12