慢性乙型肝炎患者停用核苷类似物治疗后48周结果

StephenW

48 weeks outcome after cessation of nucleos(t)ide analogue therapy in chronic hepatitis B patients
Author links open overlay panelLiGao1YueHu1XiaofengShi
XinLiDazhiZhangHongRen

    Key Laboratory of Molecular Biology for Infectious Diseases, Ministry of Education, Institute for Virus Hepatitis and Department of Infectious Diseases, the Second Affiliated Hospital of Chongqing Medical University, PR China

Received 9 July 2019, Accepted 1 October 2019, Available online 16 December 2019.
https://doi.org/10.1016/j.aohep.2019.10.006
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Abstract
Introduction and objective

The aim of the present study was to investigate the significance of serum HBsAg levels in treatment cessation of nucleoside analogues (NAs) in patients with chronic hepatitis B (CHB) infection.
Methods

In 158 CHB patients with long-term NAs treatment, 74 patients were in HBeAg negative and had a HBsAg level <1500 IU/mL, 36 of whom were informed and consented to cease NAs. HBsAg, HBV DNA and liver function were examined in the 1st, 3rd, 6th, 9th and 12th month after treatment cessation.
Results

The sustained response rate was 88.89% (32/36) within one year after NAs cessation. Sub-group analysis was based on HBsAg levels of patients with NAs cessation, there was no relapse case in 11 patients whose HBsAg <50 IU/mL, and the negative predictive value (NPV) was 100%. Seroconversion of HBsAg occurred in 3 patients. 2 patients from 21 cases whose HBsAg was between 50 IU/mL and 1000 IU/mL relapsed. 2 of 4 patients whose in HBsAg >1000 IU/mL relapsed. HBsAg of patients with a sustained response decreased slowly. In contrast, HBsAg levels increased gradually in relapsed patients, and the increase of HBsAg was precedent to relapses of HBV DNA and ALT. Multivariate analysis suggested that only HBsAg level showed a close correlation with HBV DNA relapses. ROC curve analysis suggested that the increase of HBsAg level in the 3rd and 6th month after NAs cessation had a great predictive value for relapses.
Conclusion

Monitoring of base line HBsAg level can predict outcomes of NAs cessation in HBeAg-negative chronic hepatitis B. HBsAg <50 IU/mL has higher predictive values of better sustained responses in HBeAg-negative CHB patients.
Keywords
Chronic hepatitis B
Hepatitis B virus
HBsAg quantitation
Sustained response
Nucleoside analogues
Drug cessation

StephenW

慢性乙型肝炎患者停用核苷类似物治疗后48周结果
作者链接打开覆盖面板LiGao1YueHu1XiaofengShi
新力大智张洪仁

    重庆医科大学附属第二医院，传染病分子生物学教育部重点实验室，病毒性肝炎研究所和传染病科

2019年7月9日收到，2019年10月1日接受，2019年12月16日在线可用。
https://doi.org/10.1016/j.aohep.2019.10.006
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介绍与目的

本研究的目的是调查血清HBsAg水平在慢性乙型肝炎（CHB）感染患者中停止核苷类似物（NAs）治疗的意义。
方法

在158例接受长期NAs治疗的CHB患者中，有74例HBeAg阴性且HBsAg水平低于1500 IU / mL，其中36例被告知并同意终止NAs。在停止治疗后的第1、3、6、9和12个月检查HBsAg，HBV DNA和肝功能。
结果

停用NA后一年内的持续缓解率为88.89％（32/36）。亚组分析基于NAs终止患者的HBsAg水平，其中11例HBsAg <50 IU / mL的患者中没有复发病例，阴性预测值（NPV）为100％。 HBsAg发生血清转化3例。 HBsAg在50 IU / mL至1000 IU / mL之间的21例患者中有2例复发。 HBsAg> 1000 IU / mL复发的4名患者中有2名。持续应答患者的HBsAg缓慢下降。相反，复发患者中HBsAg水平逐渐升高，而HBsAg升高是HBV DNA和ALT复发的先兆。多变量分析表明，只有HBsAg水平与HBV DNA复发密切相关。 ROC曲线分析表明，NAs终止后第3和第6个月HBsAg水平的升高对复发具有重要的预测价值。
结论

监测基线HBsAg水平可以预测HBeAg阴性慢性乙型肝炎患者NAs终止的结果。HBsAg <50 IU / mL对于HBeAg阴性CHB患者具有更好的持续反应具有更高的预测价值。
关键词
慢性乙型肝炎
乙肝病毒
HBsAg定量
持续反应
核苷类似物
戒毒

StephenW

https://www.sciencedirect.com/sc ... i/S1665268119322811

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