新兴的诊断工具，用于确定何时终止慢性乙型肝炎的核苷类

StephenW

Cells. 2020 Feb 20;9(2). pii: E493. doi: 10.3390/cells9020493.
Emerging Diagnostic Tools to Decide When to Discontinue Nucleos(t)ide Analogues in Chronic Hepatitis B.
Papatheodoridi M1,2, Papatheodoridis G2.
Author information

1
    Institute of Liver and Digestive Health, Royal Free Hospital, University College of London, London, NW3 2QG, UK.
2
    Department of Gastroenterology, Medical School of National and Kapodistrian University of Athens, General Hospital of Athens "Laiko", 11527 Athens, Greece.

Abstract

The aim of this review is to outline emerging biomarkers that can serve as diagnostic tools to identify non-cirrhotic chronic hepatitis B (CHB) patients who could safely discontinue nucleos(t)ide analogues (NAs) before HBsAg loss. Regarding possible predictors of post-NAs outcomes, a number of studies have evaluated numerous factors, which can be categorised in markers of hepatitis B virus (HBV) activity, markers of host immune response and markers of other patient characteristics. In clinical practice, the most important question for patients who discontinue NAs is to differentiate those who will benefit by achieving HBsAg loss or at least by remaining in remission and those who will relapse requiring retreatment. Most of the discontinuation studies so far came from Asian and only few from European populations and examined the rates and predictors of post-NA virological and/or combined relapses or HBsAg loss. To date, there is still controversy about predictors of post-NA relapses, while only HBsAg serum levels at NA discontinuation seem to be the most robust predictive marker of the probability of subsequent off-treatment HBsAg seroclearance. Newer viral markers such as HBV RNA and hepatitis B core-related antigen seem promising, but further research is required.
KEYWORDS:

HBcrAg; HBsAg; HBsAg loss; discontinuation; hepatitis b; nucleos(t)ide analogues; relapse; remission; retreatment

PMID:
    32093411
DOI:
    10.3390/cells9020493

StephenW

细胞。 2020年2月20日； 9（2）。 Pii：E493。 Doi：10.3390 /细胞9020493。
新兴的诊断工具，用于确定何时终止慢性乙型肝炎的核苷类似物。
Papatheodoridis M1,2，Papatheodoridis G2。
作者信息

1个
英国伦敦NW3 2QG，伦敦大学学院皇家免费医院肝与消化健康研究所。
2
雅典国立卡普迪斯安大学医学院胃肠病学系，雅典“莱科”总医院，希腊雅典11527。

抽象

这篇综述的目的是概述可以用作诊断工具的新兴生物标志物，以鉴定可以在HBsAg丢失之前安全地中断核苷酸（t）ide类似物（NAs）的非肝硬化慢性乙型肝炎（CHB）患者。关于NA后结果的可能预测因素，许多研究评估了许多因素，可以将其归类为乙型肝炎病毒（HBV）活性标记，宿主免疫反应标记和其他患者特征标记。在临床实践中，对于中止NAs的患者而言，最重要的问题是区分将通过实现HBsAg丢失或至少通过缓解而受益的患者以及那些需要再次治疗的复发患者。迄今为止，大多数中断研究均来自亚洲，只有少数来自欧洲人群，研究了NA后病毒学和/或合并复发或HBsAg损失的发生率和预测因素。迄今为止，关于NA后复发的预测因素仍存在争议，尽管在NA终止时仅HBsAg血清水平似乎是随后进行非治疗性HBsAg血清清除的最强有力的预测指标。较新的病毒标记物，例如HBV RNA和乙型肝炎核心相关抗原似乎很有希望，但需要进一步的研究。
关键字：

HBcrAg;乙肝表面抗原HBsAg丢失；停产；乙型肝炎；核苷（t）ide类似物；复发;缓解;再治疗

PMID：
32093411
DOI：
10.3390 /细胞

StephenW

https://www.mdpi.com/2073-4409/9/2/493/pdf