核苷（t）ide类似物诱导的乙型肝炎e抗原清除后，肝细胞癌和

StephenW

BMC Gastroenterol. 2020 Apr 18;20(1):113. doi: 10.1186/s12876-020-01236-9.
Cumulative incidence of hepatocellular carcinoma and hepatitis B surface antigen Seroclearance after Nucleos(t) ide analogue-induced hepatitis B e antigen Seroclearance.
Lee HW1, Lee JI1, Kim S1, Kim S1, Chang HY1, Lee KS2.
Author information

1
    Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, South Korea.
2
    Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, South Korea. [email protected].

Abstract
BACKGROUND:

Hepatitis B e antigen (HBeAg) seroclearance has been considered as the treatment endpoint in HBeAg-positive patients with chronic hepatitis B (CHB). Although HBeAg seroclearance has been accomplished, some aspects are yet unclear. We investigated the cumulative incidence of hepatocellular carcinoma (HCC) and evaluated hepatitis B surface antigen (HBsAg) seroclearance in patients undergoing nucleos(t) ide analogue (NA)-induced HBeAg seroclearance.
METHODS:

In this retrospective cohort study, 203 patients with CHB were HBsAg and HBeAg seropositive before NA (entecavir or tenofovir) treatment. All patient who experienced NA -induced HBeAg seroclearance were recruited. Patients with documented HBeAg seroclearance were followed-up every 6 months. Baseline characteristics and laboratory results were recorded.
RESULTS:

The mean age at HBeAg seroclearance was 40 years (range, 20-84), and the mean follow-up duration was 5 years (range, 2-11). The cumulative incidence of HCC was 1.5 to 11.5% at 1 to 8 years after HBeAg seroclearance. Cirrhosis was the only significant factor for HCC development (hazard ratio [HR], 24.651; confidence interval [CI], 3.018 to 201.365; P = 0.003). The cumulative incidence of HBsAg seroclearance was 3.5 to 18.7% after 1 to 8 years from HBeAg seroclearance.
CONCLUSIONS:

A significant proportion of patients developed HCC after NA-induced HBeAg seroclearance. The presence of liver cirrhosis at the time of HBeAg seroclearance serves as an independent factor for HCC development. Some patients with NA-induced HBeAg seroclearance achieved HBsAg seroclearance.
KEYWORDS:

Hepatitis B e antigen seroclearance; Hepatitis B s antigen seroclearance; Hepatitis B virus; Hepatocellular carcinoma

PMID:
    32305059
DOI:
    10.1186/s12876-020-01236-9

StephenW

BMC胃肠。 2020年4月18日； 20（1）：113。Doi：10.1186 / s12876-020-01236-9。
核苷（t）ide类似物诱导的乙型肝炎e抗原清除后，肝细胞癌和乙型肝炎表面抗原清除的累积发生率。
Lee HW1，Lee JI1，Kim S1，Kim S1，Chang HY1，Lee KS2。
作者信息

1个
延世大学医学院江南遣散医院内科，首尔市江南区恩州路211，韩国06273。
2
延世大学医学院江南遣散医院内科，首尔市江南区恩州路211，韩国06273。 [email protected]。

抽象
背景：

乙型肝炎e抗原（HBeAg）血清清除已被视为慢性乙型肝炎（CHB）的HBeAg阳性患者的治疗终点。尽管HBeAg血清清除已完成，但某些方面尚不清楚。我们调查了接受核苷（t）类似物（NA）诱导的HBeAg血清清除的患者中肝细胞癌（HCC）的累积发生率，并评估了乙型肝炎表面抗原（HBsAg）的血清清除。
方法：

在这项回顾性队列研究中，在使用NA（恩替卡韦或替诺福韦）治疗之前，有203例CHB患者的HBsAg和HBeAg血清阳性。招募了所有经历NA诱导的HBeAg血清清除的患者。每6个月对记录有HBeAg血清清除率的患者进行随访。记录基线特征和实验室结果。
结果：

HBeAg血清清除的平均年龄为40岁（范围20-84），平均随访时间为5年（范围2-11）。 HBeAg血清清除后1至8年，HCC的累积发生率为1.5至11.5％。肝硬化是肝癌发展的唯一重要因素（危险比[HR]为24.651；置信区间[CI]为3.018至201.365； P = 0.003）。从HBeAg血清清除开始1至8年后，HBsAg血清清除的累积发生率为3.5至18.7％。
结论：

NA诱导的HBeAg血清清除后，很大一部分患者发生了HCC。 HBeAg血清清除时肝硬化的存在是HCC发生的独立因素。 NA引起的HBeAg血清清除的一些患者达到HBsAg血清清除。
关键字：

乙型肝炎e抗原血清清除；乙型肝炎的抗原血清清除；乙型肝炎病毒;肝细胞癌

PMID：
32305059
DOI：
10.1186 / s12876-020-01236-9

StephenW

https://bmcgastroenterol.biomedc ... /s12876-020-01236-9