接受核苷（t）ide类似物治疗的慢性乙型肝炎患者的丙型肝炎

StephenW

J Gastroenterol Hepatol. 2020 Apr 4. doi: 10.1111/jgh.15061. [Epub ahead of print]
Serial serologic changes of hepatitis D virus in chronic hepatitis B patients receiving nucleos(t)ides analogues therapy.
Jang TY1,2, Wei YJ3, Hsu CT1, Hsu PY1, Liu TW3, Lin YH1, Liang PC1, Hsieh MH1,4,5,6,7, Ko YM1, Tsai YS1, Chen KY1, Lin CC8, Tsai PC1,4, Wang SC9, Huang CI1, Yeh ML1,10, Lin ZY1,10, Chen SC1,10, Chuang WL1,10, Huang JF1,10, Dai CY1,10,11, Huang CF1,10,12, Yu ML1,7,10,13,14.
Author information

1
    Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
2
    Department of Internal Medicine, Pingtung Hospital, Ministry of Health and Welfare, Ping-Tung, Taiwan.
3
    Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.
4
    Health Management Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
5
    Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
6
    Faculty of Internal Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
7
    Institute of Biomedical Sciences, Kaohsiung, Taiwan.
8
    Center for Liquid Biopsy, Kaohsiung Medical University, Kaohsiung, Taiwan.
9
    Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung, Taiwan.
10
    Faculty of Internal Medicine and Hepatitis Research Center, School of Medicine, College of Medicine, and Center for Cancer Research and Liquid Biopsy, Kaohsiung Medical University, Kaohsiung, Taiwan.
11
    Department of Preventive Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
12
    Department of Occupational Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
13
    Center For Intelligent Drug Systems and Smart Bio-devices (IDS2B) and Department of Biological Science and Technology, College of Biological Science and Technology, National Chiao Tung University, Hsin-Chu, Taiwan.
14
    Center for Lipid Science and Aging Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan.

Abstract
BACKGROUND/AIMS:

The long-term outcomes of hepatitis D virus (HDV) infection among chronic hepatitis B virus (HBV) infected patients who received oral nucleotide/nucleoside analogues (NUCs) is elusive.
METHODS:

Serum anti-HDV and HDV RNA among chronic hepatitis B (CHB) patients were tested at the time of initiating anti-HBV therapy and subsequently during the follow-up period.
RESULTS:

The seropositive rate of anti-HDV and HDV RNA among 2850 CHB patients, was 2.7% and 0.9%, respectively. Factors associated with anti-HDV seropositivity were platelet counts (odds ratio [OR]/95% confidence intervals [CI]: 0.995/0.992-0.999; P = 0.006), hepatitis B virus (HBV) DNA levels (OR/CI: 0.81/0.70-0.94; P = 0.005), and hepatitis B e-antigen (HBeAg) seropositivity (OR/CI: 0.22/0.05-0.95; P = 0.04). The only factor associated with HDV RNA positivity among anti-HDV seropositive patients was age (OR/CI: 0.95/0.90-1.00; P=0.03). The spontaneous clearance rate of serum anti-HDV antibody was 3.0 per 100 person-years with a median follow-up period of 3.5 years (range 2-12 years), whereas the seroclearance rate of HDV RNA was 4.3 per 100 person-years among anti-HDV seropositive patients after a median follow-up period of 6.0 years (range 2-11 years). A baseline Anti-HDV titer < 0.5 cut-off index (C.O.I.) was the only factor predictive of anti-HDV seroclearance (Hazard ratio [HR]/CI: 30.11/3.73-242.85; P=0.001).
CONCLUSIONS:

HDV infection was not common among patients treated for HBV in Taiwan. Seroclearance of anti-HDV and HDV RNA did occur over time, albeit the chance is rare.

This article is protected by copyright. All rights reserved.
KEYWORDS:

hepatitis D; nucleos(t)ides analogues; prevalence; spontaneous clearance

PMID:
    32247291
DOI:
    10.1111/jgh.15061

StephenW

J胃肠肝素。 2020年4月4日。doi：10.1111 / jgh.15061。 [Epub提前发行]
接受核苷（t）ide类似物治疗的慢性乙型肝炎患者的丙型肝炎病毒系列血清学变化。
张TY1,2，魏YJ3，许CT1，许PY1，刘TW3，林YH1，梁PC1，谢MH1,4,5,6,7，高YM1，蔡YS1，陈KY1，林CC8，蔡PC1,4 ，Wang SC9，Huang CI1，Yeh ML1,10，Lin ZY1,10，Chen SC1,10，Chuang WL1,10，Huang JF1,10，Dai CY1,10,11，Huang CF1,10,12，Yu ML1,7 ，10、13、14。
作者信息

1个
高雄医科大学附属内科肝胆科，台湾高雄。
2
卫生福利部屏东医院内科，台湾屏东。
3
台湾高雄市高雄市大同医院内科。
4
台湾高雄市高雄医科大学附属医院健康管理中心。
5
台湾高雄市高雄医科大学附属医院职业与环境医学系。
6
高雄医科大学医学院内科学院，台湾高雄。
7
台湾高雄市生物医学研究所。
8
高雄医科大学液体活检中心，台湾高雄。
9
高雄医科大学医学实验室科学与生物技术系，台湾高雄。
10
高雄医科大学医学院内科与肝炎研究中心，高雄医科大学癌症研究与液体活检中心，台湾高雄。
11
高雄医科大学预防医学系，台湾高雄。
12
高雄医科大学职业医学系，台湾高雄。
13
国立交通大学生物科学与技术学院智能药物系统与智能生物设备中心（IDS2B）和生物科学与技术系，台湾新竹。
14
高雄医科大学脂质科学与衰老研究中心，台湾高雄。

抽象
背景/目的：

在接受口服核苷酸/核苷类似物（NUCs）的慢性乙型肝炎病毒（HBV）感染患者中，乙型肝炎病毒（HDV）感染的长期结果难以捉摸。
方法：

在开始抗HBV治疗时以及随后的随访期间，对慢性乙型肝炎（CHB）患者的血清抗HDV和HDV RNA进行了检测。
结果：

2850名CHB患者中抗HDV和HDV RNA的血清反应阳性率分别为2.7％和0.9％。与抗HDV血清反应阳性相关的因素包括血小板计数（几率[OR] / 95％置信区间[CI]：0.995 /0.992-0.999；P = 0.006），乙型肝炎病毒（HBV）DNA水平（OR / CI：0.81） / 0.70-0.94; P = 0.005）和乙型肝炎e抗原（HBeAg）血清阳性（OR / CI：0.22 / 0.05-0.95; P = 0.04）。在抗-HDV血清阳性患者中，与HDV RNA阳性相关的唯一因素是年龄（OR / CI：0.95 / 0.90-1.00； P = 0.03）。血清抗HDV抗体的自发清除率为3.0每100人年，中位随访期为3.5年（范围2至12年），而HDV RNA的血清清除率为4.3每100人年。抗HDV血清反应阳性的患者，中位随访时间为6.0年（范围2-11年）。基线抗-HDV滴度<0.5临界指数（COI）是预测抗-HDV血清清除率的唯一因素（危险比[HR] / CI：30.11 /3.73-242.85；P = 0.001）。
结论：

在台湾接受乙肝病毒治疗的患者中，HDV感染并不常见。抗HDV和HDV RNA的血清清除确实会随着时间而发生，尽管这种机会很少。

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关键字：

丙型肝炎；核苷（t）ide类似物;患病率自发清除

PMID：
32247291
DOI：
10.1111 / jgh.15061