EASL2020[SAT363]差异性HBV RNA和定量HBsAg动力学之间 慢性乙型肝炎

StephenW

SAT363
Differential HBV RNA and quantitative HBsAg kinetics between
HBeAg(+) and HBeAg(−) patients with chronic hepatitis B on
nucleos(t)ide analogues (NA)
Pir Ahmad Shah1, Rizwan Ishtiaq1, Satinder Pal Kaur1, Jeffrey Gersch2,
Saad Choudhry1, Mary Kuhns2, Gavin Cloherty2, Daryl Lau1. 1Beth
Israel Deaconess Medical Center, Harvard Medical School, Medicine,
Boston, United States; 2Abbott Diagnostics, Infectious Disease Research
Email: [email protected].
Background and Aims: Functional cure with HBsAg clearance is a
desirable treatment goal. Patients with HBeAg (−) chronic hepatitis B
(CHB) have lower baseline quantitative HBsAg (qHBsAg) levels but do
not have higher rate of HBsAg loss on NA therapy.We aim to examine
the on-treatment HBV RNA and qHBsAg kinetics between HBeAg (+)
and (−) patients.Method: CHB patients on NA for at least 1 year with available stored
serial sera from baseline were included in this analysis. Serum HBV
RNA was measured using the Abbott research assay (Sensitivity: 1.65
log U/ml). Serum qHBsAg titers were determined by Abbott Architect
assay (Sensitivity: 0.05 IU/ml).
Results: This predominantly Asian (95%) cohort consisted of 29
HBeAg(+) and 12 HBeAg(−) CHB patients. The duration of therapy was
similar for the HBeAg (+) and (−) groups (58 vs. 55 months, p = 0.9).14
subjects achieved HBeAg loss after 5 to 74 months of therapy. None of
the HBeAg(−) subjects had functional cure. The HBeAg(−) patients
had significantly lower baseline DNA, RNA and qHBsAg levels
compared to the HBeAg(+) ones, and reached optimal HBV DNA
suppression (<1.3 log IU/ml) fastest. The decline of RNA and qHBsAg
from baseline to time of DNA <1.3 log IU/ml, in contrast, was much
slower among the HBeAg(−) patients [Table]. The 14 patients who
achieved HBeAg loss had the greatest initial reduction in RNA and
qHBsAg levels associated with HBV DNA suppression. At last follow
up, 5 of 14(35%) had RNA <1.65 U/ml but only 1 had HBsAg loss. In
contrast, none of the patients who remained HBeAg(+), and only 5
(42%) HBeAg(−) patients, achieved RNA <1.65 U/ml. The annual log
reduction of qHBsAg from baseline to last follow up was significantly
slower among the HBeAg(−) patients. [Table].
Conclusion: In this cohort, HBV RNA kinetics differentiated HBeAg
(+) CHB patients with and without HBeAg loss on long-term NA
therapy. HBeAg(−) subjects achieved optimal HBV DNA suppression
the fastest but had the slowest decline in HBV RNA and qHBsAg levels
over time. The kinetics of HBV RNA and qHBsAg decline elucidated
the low rate of treatment-related HBsAg loss among the HBeAg(−)
patients.

StephenW

SAT363
差异性HBV RNA和定量HBsAg动力学之间
慢性乙型肝炎的HBeAg（+）和HBeAg（-）患者
核苷（核苷酸）类似物（NA）
Pir Ahmad Shah1，Rizwan Ishtiaq1，Satinder Pal Kaur1，Jeffrey Gersch2，
Saad Choudhry1，Mary Kuhns2，Gavin Cloherty2，Daryl Lau1。 1贝斯
以色列医学院，以色列女执事医学中心，
美国波士顿； 2Abbott诊断，传染病研究
电子邮件：[email protected]。
背景与目的：清除HBsAg的功能性治愈是一个
理想的治疗目标。 HBeAg（-）慢性乙型肝炎患者
（CHB）的基线定量HBsAg（qHBsAg）水平较低，但确实
在NA疗法中HBsAg丢失率较高。我们旨在检查
HBeAg（+）之间的治疗中HBV RNA和qHBsAg动力学
方法：CHB的NA患者至少保存1年，并有可用的存储空间
从基线开始的连续血清包括在该分析中。血清乙肝病毒
使用Abbott研究测定法测量RNA（灵敏度：1.65
log U / ml）。血清qHBsAg滴度由Abbott Architect确定
测定（灵敏度：0.05IU / ml）。
结果：这个主要由亚洲人（95％）组成的队列包括29个
HBeAg（+）和12位HBeAg（-）CHB患者。治疗时间为
HBeAg（+）和（-）组的情况相似（58 vs. 55个月，p = 0.9）.14
受试者在治疗5到74个月后实现了HBeAg丢失。没有
HBeAg（-）受试者已治愈。 HBeAg（-）患者
基线DNA，RNA和qHBsAg水平明显降低
与HBeAg（+）相比，达到最佳HBV DNA
抑制（<1.3 log IU / ml）最快。 RNA和qHBsAg的下降
相反，从基线到DNA小于1.3 log IU / ml的时间
在HBeAg（-）患者中速度较慢[表]。谁的14例
达到的HBeAg损失最初具有最大的RNA减少，
与HBV DNA抑制相关的qHBsAg水平。最后跟随
多达14个样本中有5个（35％）的RNA <1.65 U / ml，但只有1个HBsAg丢失。在
相比之下，剩下的HBeAg（+）患者中没有一个，只有5个
（42％）HBeAg（-）患者，RNA <1.65 U / ml。年度日志
从基线到最后一次随访，qHBsAg的降低显着
在HBeAg（-）患者中速度较慢。 [表]。
结论：在这个队列中，HBV RNA动力学区分了HBeAg
（+）长期NA不伴或不伴HBeAg丢失的CHB患者
治疗。 HBeAg（-）受试者获得了最佳的HBV DNA抑制
最快但最慢的HBV RNA和qHBsAg水平下降
随着时间的推移。阐明了HBV RNA和qHBsAg下降的动力学
HBeAg（-）中与治疗相关的HBsAg丢失率低
耐心。