“如果表面抗原消失，乙型肝炎患者可以停止抗病毒药物治

StephenW

‘Hepatitis B patients can stop antiviral drug if surface antigen disappears’

    By Kim Yoon-mi
    Published 2020.04.06 15:32
    Updated 2020.04.06 15:32
   
Chronic hepatitis type B patients who got rid of hepatitis B virus surface antigen (HBsAg) through long-term medication can discontinue the antiviral treatment, local researchers said in a study.

Professor Lee Jeong-hoon at the Department of Internal Medicine and Liver Research Institute at Seoul National University College of Medicine and his research team released the study, jointly conducted by 16 university hospitals, on Friday.
Professor Lee Jeong-hoon of the Department of Internal Medicine and Liver Research Institute at Seoul National University College of Medicine

Chronic hepatitis B affects about 260 million people worldwide. The disease is particularly common in East Asia, including Korea.

In the past, physicians used antiviral treatments to treat chronic hepatitis B. If the viral suppression by antiviral drugs goes successful and the patient tests negative for HBsAg, the patient is considered to have achieved “a functional cure.”

However, hepatitis B patients could not discontinue the antiviral treatment even after a functional cure because discontinuation of the antiviral drug could reactivate the virus and worsen liver functions. Such a case may lead to liver failure or even death.

Thus, patients with hepatitis B had no choice but to take the medication for the long term and come to terms with the risk of drug resistance, side effects, and financial burden.

The research team analyzed 276 patients from 16 hospitals whose long-term antiviral medications removed HBsAg. Then, the team compared the results of 131 who discontinued antiviral drug within six months after HBsAg cleared with those of 145 who continued the drug.

The researchers found that there was no difference between the two groups in terms of HBsAg reversion, serum hepatitis B virus DNA re-detection, or hepatocellular carcinoma risk.

The latest study was expected to be used as a basis for determining when to end chronic hepatitis B patient’s antiviral treatment, the researchers said.

It was the largest real-world, multicenter cohort study that directly compared the discontinuation with the continuation of the antiviral drug for the first time, they added.

“Since cirrhosis and previous history of antiviral resistance might be associated with a higher risk for HBsAg reversion and hepatitis B virus DNA re-detection, respectively, those patients require more attention and further prospective studies with larger sample size are warranted,” the research team noted.

The study was published in the online version of Gut, a medical journal by the British Society of Gastroenterology, on March 25.

[email protected]

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StephenW

“如果表面抗原消失，乙型肝炎患者可以停止抗病毒药物治疗”

    金允美
    发表2020.04.06 15:32
    更新的2020.04.06 15:32
   
当地研究人员在一项研究中说，通过长期用药摆脱了乙型肝炎病毒表面抗原（HBsAg）的慢性乙型肝炎患者可以终止抗病毒治疗。

首尔国立大学医学院内科学与肝脏研究所的李正勋教授及其研究小组于周五发布了由16家大学医院共同进行的研究。
首尔大学医学院内科学与肝脏研究所李正勋教授

慢性乙型肝炎影响全世界约2.6亿人。该病在包括韩国在内的东亚尤其常见。

过去，医生曾使用抗病毒药物治疗慢性乙型肝炎。如果抗病毒药物对病毒的抑制作用成功，并且患者的HBsAg检测阴性，则认为该患者已达到“功能性治愈”。

但是，即使在功能治愈后，乙肝患者也无法停止抗病毒治疗，因为停止使用抗病毒药物可能会重新激活病毒并恶化肝功能。这种情况可能导致肝功能衰竭甚至死亡。

因此，乙型肝炎患者别无选择，只能长期服用药物，并具有耐药性，副作用和经济负担的风险。

研究小组分析了来自16家医院的276名长期抗病毒药物去除了HBsAg的患者。然后，研究小组将131种在HBsAg清除后六个月内停用抗病毒药的结果与145种继续使用该药的结果进行了比较。

研究人员发现，在HBsAg逆转，血清乙型肝炎病毒DNA重新检测或肝细胞癌风险方面，两组之间没有差异。

研究人员说，最新的研究有望作为确定何时终止慢性乙型肝炎患者抗病毒治疗的基础。

他们补充说，这是最大的，真实的，多中心的队列研究，首次将抗病毒药物的停用和持续使用直接进行了比较。

“由于肝硬化和先前的抗病毒抗药史可能分别与HBsAg逆转和乙型肝炎病毒DNA重新检测的较高风险有关，因此这些患者需要更多的关注，因此有必要进行更大样本量的前瞻性研究，”研究团队注意。

该研究于3月25日发表在英国胃肠病学医学杂志在线版中。

[email protected]

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