停用或维持恩替卡韦治疗的HBeAg阴性患者中HBsAg变化的比较

StephenW

Comparison of HBsAg changes between HBeAg-negative patients who discontinued or maintained entecavir therapy

    Chien-Hung Chen, Tsung-Hui Hu, Jing-Houng Wang, Hsueh-Chou Lai, Chao-Hung Hung, Sheng-Nan Lu & Cheng-Yuan Peng

Hepatology International volume 14, pages317–325(2020)Cite this article

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Abstract
Background/purpose

The study compared the hepatitis B surface antigen (HBsAg) changes between hepatitis B e antigen (HBeAg)-negative non-cirrhotic chronic hepatitis B patients who discontinued or maintained entecavir therapy.
Methods

A total of 250 HBeAg-negative, non-cirrhotic patients who were treated with entecavir previously and had stopped treatment for at least 12 months (discontinued group) and 231 HBeAg-negative, non-cirrhotic patients who had received entecavir treatment for at least 4 years (maintained group) were recruited.
Results

In the discontinued group, 71 had a persistent virological suppression (Group I), 35 experienced virological relapse but no clinical relapse or retreatment (Group II), 26 experienced clinical relapse without retreatment (Group III), and 118 experienced HBV relapse and retreatment (Group IV). Patients in Groups I, II, and III, but not in Group IV, experienced a significantly larger drop in HBsAg levels’ post-treatment than during entecavir treatment. Patients in Groups I and III exhibited a greater post-treatment HBsAg decline than patients in Groups II and IV (p < 0.001). Discontinued group experienced a significantly larger drop in HBsAg levels (p < 0.001) and higher HBsAg loss rate (p = 0.001) than maintained group after adjusting for clinical features and HBsAg levels in propensity score matched patients. Patients in maintained group exhibited a smaller drop in HBsAg and lower HBsAg loss rate than patients in groups I, II, and III, but not in Group IV.
Conclusions

Patients who discontinued entecavir therapy and achieved persistent virological suppression exhibited a greater HBsAg decline and higher HBsAg loss rate compared with patients who maintained entecavir therapy.

StephenW

停用或维持恩替卡韦治疗的HBeAg阴性患者中HBsAg变化的比较

    陈建雄，胡宗辉，王静雄，赖学超，洪朝雄，卢胜男和彭成元

《国际肝病学》第14卷，第317–325页（2020年）

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抽象
背景/目的

该研究比较了停用或维持恩替卡韦治疗的慢性乙型肝炎非乙型肝炎患者中乙型肝炎e抗原（HBeAg）阴性的乙型肝炎表面抗原（HBsAg）的变化。
方法

总共250例接受恩替卡韦治疗且停止治疗至少12个月的HBeAg阴性非肝硬化患者（停药组）和231例接受恩替卡韦治疗至少4例HBeAg阴性非肝硬化患者年（维持组）。
结果

在停药组中，有71例持续病毒学抑制（I组），35例病毒学复发但无临床复发或复发（II组），26例未经治疗而临床复发（III组）和118例HBV复发和复发（组）。第四组）。与恩替卡韦治疗期间相比，I，II和III组（而非IV组）的患者治疗后HBsAg水平下降幅度明显更大。与第二和第四组相比，第一和第三组的患者治疗后HBsAg下降更大（p <greater0.001）。调整倾向得分匹配患者的临床特征和HBsAg水平后，停药组的HBsAg水平下降显着更大（p << 0.001），HBsAg丢失率更高（p = 0.001）。与I，II和III组相比，维持组患者的HBsAg下降较小，HBsAg丢失率较低，而IV组则没有。
结论

与维持恩替卡韦治疗的患者相比，停止恩替卡韦治疗并获得持续病毒学抑制的患者表现出更大的HBsAg下降和更高的HBsAg丢失率。

s-3

回复 StephenW 的帖子

结论是可以停止抗病毒治疗了？
我服用恩替卡韦10年，服药后病毒一直是阴性，肝功也正常，是不是可以试着停药了。

StephenW

回复 s-3 的帖子

不是可以停止抗病毒治疗, 是可以试着停药了.

1. 肝硬化患者不应该停止.
2. 停药需要由经验丰富的HBV专家进行监督, 因为大多数人将需要重新开始服药, 关键是何时.
停药后, ALT 会升起, HBDVNA将上升, 对于某些人 ,这些只是暂时的（约40％), 其余的需要重新治疗.
3. 检查您的血清HbsAg水平，越低越好机会.