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AASLD2020[730]慢性HBV PGRNA動力學特徵 乙型肝炎患者接受核苷(T [复制链接]

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62111 元 
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发表于 2020-10-23 15:54 |只看该作者 |倒序浏览 |打印
730
HBV PGRNA DYNAMICS CHARACTERISTICS AMONG CHRONIC
HEPATITIS B PATIENTS RECEIVING NUCLEOS(T)IDE
ANALOGUE TREATMENT.
Hao Luo, Jinghang Xu, Ran Cheng, Yifan Han, Qian Kang,
Ning Tan, Jiali Pan, Hongyu Chen, Yuqing Yang and Xiaoyuan
Xu, Peking University First Hospital
Background: The dynamics characteristics of HBV pgRNA
during treatment of chronic hepatitis B (CHB) patients with
nucleos(t)ide analogues (NAs) still lack thorough study
Methods: We enrolled 110 patients to evaluate the dynamics
characteristics of HBV pgRNA According to strict inclusion
and exclusion criteria, 50 patients were included in without
partial virological response (group A), and 43 patients were
included in the partial virological response group (group B)
They were receiving NA treatment for over 7 years, and during
the follow-up, serum and clinical information were collected
every 6 months HBV pgRNA was detected by real-time
quantitative PCR with specific probes. Results: In groups A
and B, the average age, ALT, HBV DNA and HBV pgRNA were
similar; group B had more males and HBeAg-positive patients
(P=0 00) During the 7-year treatment, ALT, HBV DNA and
HBV pgRNA continued to decline; after long-term treatment,
the viral markers trended towards normal At the beginning of
treatment, HBV pgRNA had an elevated trend ALT declined
rapidly in groups A and B. The HBV DNA in group B fluctuated
for some time The HBV pgRNA in group B increased at the
beginning of treatment and then declined as in group A The
HBV pgRNA in group A remained steady at the beginning
of treatment Then, HBV DNA became undetectable Thus,
the HBV pgRNA undetectable time and ALT normal time of
patients during follow-up were analyzed In group A, the HBV
DNA undetectable time was shorter than the HBV pgRNA
undetectable time (P=0 00) The ALT normal time was shorter
than the HBV pgRNA undetectable time (P=0 00) In group
B, the HBV DNA undetectable time was longer than the HBV
pgRNA undetectable time (P=0 00) The ALT normal time
was also shorter than the HBV pgRNA undetectable time
(P=0 00) Finally, we used mixed linear models to analyze the
factors independently associated with HBV pgRNA dynamics
The fixed effects included age, gender, treatment NA type,
treatment time, type of virological response, ALT and HBV DNA
(log10 IU/ml), and the random effects included the IDs of the
patients The results showed that only the presence of partial
virological response (P=0 00) and treatment time (P=0 00)
were statically significant. The pgRNA level of the group A was
less than that of the group B by 1 28 log10 IU/ml, and the 95%
confidence interval was 1.80~0.75 log10 IU/ml When patients
underwent NA treatment, the pgRNA decreased 1 29 log10
IU/ml every year until it became undetectable, and the 95%
confidence interval was 2.15~0.43 log10 IU/ml Conclusion:
The dynamics of pgRNA could independently reflect the
effect of antiviral treatment The HBV pgRNA level of partial
virological response patients was higher than that of patients
without partial virological response by 1 28 log10 IU/ml When
patients underwent NA treatment, the pgRNA decreased 1 29
log10 IU/ml every year until it became undetectable.

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62111 元 
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26 
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30437 
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最后登录
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才高八斗

2
发表于 2020-10-23 15:54 |只看该作者
730
慢性HBV PGRNA動力學特徵
乙型肝炎患者接受核苷(T)
模擬治療。
羅昊,徐靜航,程然,韓一凡,錢康,
譚寧,潘佳麗,陳宏宇,楊玉清和小元
徐,北京大學第一醫院
背景:HBV pgRNA的動力學特徵
在慢性乙型肝炎(CHB)患者治療期間
核苷酸類似物(NAs)仍缺乏深入研究
方法:我們招募了110名患者來評估動態
嚴格納入的HBV pgRNA的特徵
和排除標準,將50例患者納入
部分病毒學應答(A組),其中43例為
包括在部分病毒學應答組(B組)中
他們接受了NA治療超過7年,在此期間
隨訪,收集血清和臨床信息
每6個月實時檢測一次HBV pgRNA
用特異性探針進行定量PCR。結果:A組
和B,平均年齡,ALT,HBV DNA和HBV pgRNA為
類似; B組有更多男性和HBeAg陽性患者
(P = 0 00)在7年的治療期間,ALT,HBV DNA和
HBV pgRNA繼續下降;經過長期治療
病毒標記趨向正常
治療,HBV pgRNA有升高的趨勢,ALT下降
A和B組的感染迅速。B組的HBV DNA波動
在一段時間內,B組的HBV pgRNA在
開始治療,然後如A組一樣下降
開始時,A組的HBV pgRNA保持穩定
治療之後,HBV DNA變得不可檢測
HBV pgRNA不可檢測時間和ALT正常時間
隨訪期間對患者進行分析在A組中,HBV
DNA不可檢測時間短於HBV pgRNA
不可檢測時間(P = 0 00)ALT正常時間較短
比HBV pgRNA不可檢測的時間(P = 0 00)
B,HBV DNA檢出時間比HBV長
pgRNA不可檢測時間(P = 0 00)ALT正常時間
還比HBV pgRNA不可檢測的時間短
(P = 0 00)最後,我們使用混合線性模型來分析
與HBV pgRNA動力學獨立相關的因素
固定影響包括年齡,性別,治療NA類型,
治療時間,病毒學應答類型,ALT和HBV DNA
(log10 IU / ml),隨機效應包括
患者結果表明,僅部分存在
病毒學應答(P = 0 00)和治療時間(P = 0 00)
具有靜態意義。 A組的pgRNA水平為
比B組少1 28 log10 IU / ml,95%
患者置信區間為1.80〜0.75 log10 IU / ml
接受NA治療後,pgRNA下降了1 29 log10
每年IU / ml,直到無法檢測到為止,並且95%
置信區間為2.15〜0.43 log10 IU / ml結論:
pgRNA的動力學可以獨立反映
抗病毒治療的效果HBV pgRNA部分水平
病毒學應答患者高於患者
1 28 log10 IU / ml時無部分病毒學應答
患者接受NA治療後,pgRNA下降1 29
每年log10 IU / ml,直到無法檢測到為止。
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