核苷酸类似物治疗HBeAg阳性慢性乙型肝炎患者血清HBV RNA双相

StephenW

Factors Associated With the Biphasic Kinetics of Serum HBV RNA in Patients With HBeAg-positive Chronic Hepatitis B Treated With Nucles(t)ide Analogues
Shi Liu  1 , Zhihong Liu  1 , Wanying Li  1 , Bin Zhou  1 , Xieer Liang  1 , Rong Fan  1 , Rui Deng  1 , Jinlin Hou  1 , Jian Sun  1
Affiliations
Affiliation

    1
    State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China.

    PMID: 32613672 DOI: 10.1111/apt.15890

Abstract

Background: Serum hepatitis B virus (HBV) RNA is a novel biomarker for evaluating treatment response. Detailed information regarding serum HBV RNA kinetics during treatment with nucles(t)ide analogues (NAs) is limited.

Aims: To ascertain serum HBV RNA kinetics during long-term NAs treatment and identify associated factors.

Methods: We enrolled 76 HBeAg-positive chronic hepatitis B patients receiving NAs from randomised controlled trials. Laboratory assays were undertaken every 3 months. Factors associated with serum HBV RNA kinetics were identified by generalised estimating equations.

Results: Baseline serum HBV RNA was 8.5 ± 1.0 log10 copies/mL. Decline in serum HBV RNA during NAs therapy was biphasic: the first phase (HBV DNA detectable) had a fast decrease (median slope, -0.207 log10 copies/mL/month) and was followed by a second phase (HBV DNA undetectable) with slow decrease (median slope, -0.071 log10 copies/mL/month). In the first phase, factors independently associated with lower initial serum HBV RNA were male sex (OR, 0.685, P = 0.044), low baseline HBsAg (OR, 0.525, P = 0.001) and rapid virological response (RVR) (OR, 0.624, P = 0.031). In the second phase, only RVR was independently associated with serum HBV RNA kinetics, including its lower initial level (OR, 0.694, P = 0.043) and greater decline (OR, 0.966, P = 0.002). Based on viral dynamics, time needed to achieve undetectable serum HBV RNA from baseline was 43.56 (IQR: 29.49-66.40) months.

Conclusion: RVR was a significant determinant for biphasic decline in serum HBV RNA during NAs treatment, which significantly influenced the treatment duration required to achieve undetectable serum HBV RNA.

© 2020 John Wiley & Sons Ltd.

StephenW

核苷酸类似物治疗HBeAg阳性慢性乙型肝炎患者血清HBV RNA双相动力学相关因素
刘世1，刘志宏1，李万应1，周斌1，谢尔梁1，荣凡1，邓登1，侯金林1，孙建1
隶属关系
联系

    1个
    南方医科大学附属南方医院传染病科，器官衰竭研究国家重点实验室，广东省病毒性肝炎研究重点实验室，广州。

    PMID：32613672 DOI：10.1111 / apt.15890

抽象

背景：血清乙型肝炎病毒（HBV）RNA是用于评估治疗反应的新型生物标志物。关于用核苷类似物（NAs）治疗期间血清HBV RNA动力学的详细信息有限。

目的：在长期NAs治疗期间确定血清HBV RNA动力学并确定相关因素。

方法：我们招募了76名接受随机对照试验NAs的HBeAg阳性慢性乙型肝炎患者。每3个月进行实验室测定。通过广义估计方程确定与血清HBV RNA动力学相关的因素。

结果：基线血清HBV RNA为8.5±1.0 log10拷贝/ mL。 NAs治疗期间血清HBV RNA的下降是双相的：第一阶段（可检测到HBV DNA）快速下降（中位斜率，-0.207 log10拷贝/ mL /月），第二阶段（未检测到HBV DNA）缓慢减少（中位数斜率，-0.071 log10拷贝/ mL /月）。在第一阶段，与较低的初始血清HBV RNA独立相关的因素是男性（OR，0.685，P = 0.044），基线HBsAg低（OR，0.525，P = 0.001）和快速病毒学应答（RVR）（OR，0.624） ，P = 0.031）。在第二阶段，只有RVR与血清HBV RNA动力学独立相关，包括其较低的初始水平（OR，0.694，P = 0.043）和较大的下降（OR，0.966，P = 0.002）。根据病毒动力学，从基线达到无法检测的血清HBV RNA所需的时间为43.56（IQR：29.49-66.40）个月。

结论：RVR是NAs治疗期间血清HBV RNA双相下降的重要决定因素，这显着影响达到无法检测的血清HBV RNA所需的治疗时间。

分级为4 +©2020 John Wiley＆Sons Ltd.

StephenW

https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/apt.15890