核苷酸（t）类似物对慢性乙型肝炎患者血清HBsAg水平的影响

StephenW

Biomed Pharmacother. 2019 Dec 9;122:109698. doi: 10.1016/j.biopha.2019.109698. [Epub ahead of print]
Effect of nucleos(t)ide analogue on serum HBsAg level in chronic hepatitis B patients: A 3-years study.
Zheng Z1, Liao W2, Liu L3, Cai S4, Zhu H5, Yin S6.
Author information

1
    Department of Infectious Diseases, DongGuan People's Hospital, Southern Medical University, DongGuan, China.
2
    Intensive Care Unit, Sun Yat-sen University Cancer Center, Guangdong Province, China.
3
    Department of Pathology, Sun Yat-sen University Cancer Center, Guangdong Province, China.
4
    Department of Infectious Diseases and Hepatology Unit, NanFang Hospital, Southern Medical University, Guangzhou, China. Electronic address: [email protected].
5
    Department of Infectious Diseases, The Ninth People's hospital of DongGuan, China.
6
    Department of Infectious Diseases, DongGuan People's Hospital, Southern Medical University, DongGuan, China. Electronic address: [email protected].

Abstract
AIM:

We aim to explore the effects of nucleos(t)ide analogues (NUCs) on the changes of HBsAg in chronic hepatitis B (CHB) patients.
METHODS:

A total of 264 CHB patients were enrolled in our study. All of them were treated with NUCs for at least three years. Quantification of HBsAg levels were measured by Elecsys HBsAg II.
RESULTS:

Although HBsAg levels were significantly higher in HBeAg seropositive CHB patients at baseline than in HBeAg seronegative CHB patients (3.84 ± 0.82 vs 3.21 ± 0.59 IU/mL), HBsAg levels declined more rapidly in the HBeAg seropositive group (P < 0.001). In HBeAg-positive CHB patients, HBsAg level in the telbivudine (LDT)-treated group was 3.68 ± 0.56 IU/mL after 52-week of treatment, which was significantly higher than that in lamivudine (LAM)-treated group (P = 0.009). Multivariable analyses showed that baseline HBV DNA viral load (OR = 0.75, P = 0.018), baseline ALT level (OR = 0.99, P = 0.015), and baseline HBsAg level (OR = 0.188, P < 0.001) were independent factors that affected HBsAg decline in HBeAg seropositive CHB patients. For HBeAg seronegative CHB patients, the average of serum HBsAg levels in LAM-, LdT-, adefovir (ADV)-, and entecavir (ETV)-treated groups at baseline, 52 weeks, 104 weeks, and 156 weeks were similar. Multivariable analyses showed that only baseline HBV DNA level (OR = 0.56, P = 0.020) and baseline HBsAg level (OR = 0.57, P = 0.012) were independent factors that affected HBsAg decline in HBeAg seronegative patients with CHB. Baseline HBV DNA level (OR = 0.72, P = 0.010) and baseline HBsAg level (OR = 0.19, P < 0.001) were independent factors that affected all CHB patients.
CONCLUSIONS:

CHB Patients who had received NUCs antiviral treatment showed a slow but significant decrease in serum HBsAg level. Long-term monitoring and continuous antiviral treatment are necessary, especially for those patients with risk factors associated with HBsAg decline.

Copyright © 2019 The Authors. Published by Elsevier Masson SAS.. All rights reserved.
KEYWORDS:

Antiviral treatment; Chronic hepatitis B; HBsAg decline; Nucleoside analogues

PMID:
    31918272
DOI:
    10.1016/j.biopha.2019.109698

StephenW

生物医药师。 2019十二月9; 122：109698。 doi：10.1016 / j.biopha.2019.109698。 [Epub提前发布]
核苷酸（t）类似物对慢性乙型肝炎患者血清HBsAg水平的影响：一项为期3年的研究。
郑Z1，廖W2，刘L3，蔡S4，朱H5，尹S6。
作者信息

1个
    南方医科大学附属东莞人民医院传染病科，广东东莞。
2
    中国广东省中山大学肿瘤防治中心重症监护室。
3
    中山大学附属肿瘤中心病理科，广东省。
4
    南方医科大学南方医院传染病与肝病科，广东广州电子地址：[email protected]。
5
    东莞市第九人民医院传染病科。
6
    南方医科大学附属东莞人民医院传染病科，广东东莞。电子地址：[email protected]。

抽象
目标：

我们旨在探讨核苷酸（t）的类似物（NUCs）对慢性乙型肝炎（CHB）患者HBsAg变化的影响。
方法：

我们的研究共纳入264位CHB患者。他们都接受了NUC治疗至少三年。 HBsAg水平的定量通过Elecsys HBsAg II进行测量。
结果：

尽管基线时HBeAg血清阳性CHB患者的HBsAg水平显着高于HBeAg血清阴性CHB患者（3.84±±0.82 vs 3.21±±0.59 IU / mL），但HBeAg血清阳性组的HBsAg水平下降较快（P <0.001）。在HBeAg阳性CHB患者中，替比夫定（LDT）治疗组在治疗52周后的HBsAg水平为3.68±0.56 IU / mL，显着高于拉米夫定（LAM）治疗组（P = 0.009） ）。多变量分析显示基线HBV DNA病毒载量（OR = 0.75，P = 0.018），基线ALT水平（OR = 0.99，P = 0.015）和基线HBsAg水平（OR = 0.188，P <0.001）是影响这些因素的独立因素HBeAg血清阳性CHB患者的HBsAg下降。对于HBeAg血清阴性的CHB患者，在基线，52周，104周和156周时，LAM-，LdT-，阿德福韦（ADV）-和恩替卡韦（ETV）治疗组的血清HBsAg平均水平相似。多变量分析显示，基线HBV DNA水平（OR = 0.56，P = 0.020）和基线HBsAg水平（OR = 0.57，P = 0.012）是影响HBeAg血清阴性的CHB患者HBsAg下降的独立因素。基线HBV DNA水平（OR = 0.72，P = 0.010）和基线HBsAg水平（OR = 0.19，P <0.001）是影响所有CHB患者的独立因素。
结论：

已接受NUCs抗病毒治疗的CHB患者血清HBsAg水平缓慢但显着下降。长期监测和持续抗病毒治疗是必要的，特别是对于那些具有与HBsAg下降相关的危险因素的患者。

版权所有©2019 The Authors。由Elsevier Masson SAS发布。保留所有权利。
关键字：

抗病毒治疗；慢性乙型肝炎； HBsAg下降；核苷类似物

PMID：
    31918272
DOI：
    10.1016 / j.biopha.2019.109698

StephenW

https://www.sciencedirect.com/sc ... 1935320X?via%3Dihub