HBsAg定量预测了慢性乙型肝炎患者对干扰素的非治疗反应：一

StephenW

BMC Gastroenterol. 2020 Apr 21;20(1):121. doi: 10.1186/s12876-020-01263-6.
HBsAg quantification predicts off-treatment response to interferon in chronic hepatitis B patients: a retrospective study of 250 cases.
Wu S1, Luo W1, Wu Y1, Chen H1, Peng J2.
Author information

1
    Department of Infectious Diseases, Nanfang Hospital of Southern Medical University, Guangzhou, 510515, China.
2
    Department of Infectious Diseases, Nanfang Hospital of Southern Medical University, Guangzhou, 510515, China. [email protected].

Abstract
BACKGROUND:

For chronic hepatitis B (CHB) patients without willingness to extend the routine duration of interferon (IFN) therapy, it is important to identify patients who will benefit from treatment cessation. Hepatitis B surface antigen (HBsAg) quantification is recommended for management of IFN therapy. At present, the understanding on end-of-treatment (EOT) HBsAg level predicting post-treatment response to IFN is still finite.
METHODS:

A total of 2451 non-cirrhosis, HBsAg-postive patients treated with IFN-based therapy during the period from December 2010 to December 2017 at Nanfang Hospital were enrolled in this study. Serum HBsAg levels at EOT were measured to evaluate the associations between EOT HBsAg levels (Group 1, HBsAg > 0.05 and ≤ 10 IU/mL; Group 2, HBsAg > 10 and ≤ 200 IU/mL; Group 3, HBsAg > 200 IU/mL) with post-treatment HBsAg loss. Chi-squared, t-test,,Kaplan-Meier analysis, Cox regression analysis, and Multivariate Logistic regression analysis were used to analyse and evaluate differences between the there groups.
RESULTS:

The cumulative HBsAg loss rates 5 years after treatment in Group 1-3 were 30.4% (17/56), 9.8%(4/41) and 0%(0/153) (p < 0.001). An EOT HBsAg level of > 10 IU/mL showed relatively high negative predictive value (NPV) of up to 97.9% for HBsAg loss. Low baseline HBsAg level < 25,000 IU/mL, on-treatment HBsAg decline > 1 log10IU/mL at week 24 and EOT HBsAg level ≤ 10 IU/mL were found significantly associated with HBsAg loss. A total of 6 patients have achieved HBsAg loss at EOT and 17 patients with EOT HBsAg level ≤ 10 IU/mL have achieved post-treatment HBsAg loss. Baseline characteristics, dynamic changes of on-treatment HBsAg and duration of IFN therapy were balanced across patients with EOT or post-treatment HBsAg loss.
CONCLUSION:

EOT HBsAg level can serve as a monitoring indicator for IFN therapy. EOT HBsAg level ≤ 10 IU/mL was found to lead to high rate of post-treatment HBsAg loss. For patients without willingness to extend IFN treatment, off-treatment follow-up could be considered when HBsAg level decreased to ≤10 IU/mL.
KEYWORDS:

Chronic hepatitis B; End-of-treatment; Hepatitis B surface antigen; Interferon; Post-treatment response

PMID:
    32316928
DOI:
    10.1186/s12876-020-01263-6

StephenW

BMC胃肠。 2020 Apr 21; 20（1）：121。 doi：10.1186 / s12876-020-01263-6。
HBsAg定量预测了慢性乙型肝炎患者对干扰素的非治疗反应：一项对250例病例的回顾性研究。
Wu S1，Luo W1，Wu Y1，Chen H1，Peng J2。
作者信息

1个
    南方医科大学附属南方医院感染科，广东广州510515
2
    南方医科大学附属南方医院感染科，广东广州510515 [email protected]。

抽象
背景：

对于不愿意延长干扰素（IFN）治疗常规持续时间的慢性乙型肝炎（CHB）患者，重要的是确定将从停止治疗中受益的患者。建议使用乙型肝炎表面抗原（HBsAg）进行IFN治疗。目前，关于治疗结束（EOT）HBsAg水平预测对IFN的治疗后反应的认识仍然有限。
方法：

2010年12月至2017年12月在南方医院接受IFN治疗的2451名非肝硬化HBsAg阳性患者入选本研究。测量EOT时的血清HBsAg水平以评估EOT HBsAg水平之间的相关性（第1组，HBsAg> 0.05且≤≤10IU / mL;第2组，HBsAg> 10且≤≤200IU / mL;第3组，HBsAg> 200 IU / mL毫升）治疗后HBsAg丢失。卡方检验，t检验，Kaplan-Meier分析，Cox回归分析和多元Logistic回归分析用于分析和评估两组之间的差异。
结果：

1-3组治疗后5年的HBsAg累积丢失率分别为30.4％（17/56），9.8％（4/41）和0％（0/153）（p <0.001）。 EOT HBsAg水平> 10 IU / mL时，HBsAg丢失的阴性预测值（NPV）相对较高，高达97.9％。发现基线低HBsAg水平<< 25,000 IU / mL，治疗后HBsAg下降> 24 log1IU / mL> 1 log10IU / mL，而EOT HBsAg水平≤≤10/ IU / mL与HBsAg损失显着相关。共有6例患者在EOT时达到了HBsAg丢失，而17例EOT HBsAg水平≤≤10IU / mL的患者在治疗后达到了HBsAg丢失。在EOT或治疗后HBsAg丢失的患者中，基线特征，治疗中HBsAg的动态变化和IFN治疗的持续时间是平衡的。
结论：

EOT HBsAg水平可以作为IFN治疗的监测指标。发现EOT HBsAg水平≤10IU / mL会导致治疗后HBsAg丢失率高。对于不愿延长IFN治疗的患者，当HBsAg水平降至≤10IU / mL时，可以考虑进行治疗后的随访。
关键字：

慢性乙型肝炎；治疗结束；乙型肝炎表面抗原；干扰素治疗后反应

PMID：
    32316928
DOI：
    10.1186 / s12876-020-01263-6

StephenW

https://bmcgastroenterol.biomedc ... /s12876-020-01263-6