一线口服抗病毒治疗对慢性乙型肝炎患者的血清HBcrAg抑制作

StephenW

First-line oral antiviral therapies showed similar efficacies in suppression of serum HBcrAg in chronic hepatitis B patients
Lung-Yi Mak  1   2 , Danny Ka-Ho Wong  1   2 , Ka-Shing Cheung  1   3 , Wai-Kay Seto  1   2 , James Fung  1   2 , Man-Fung Yuen  4   5
Affiliations
Affiliations

    1
    Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam Road 102,, Pok Fu Lam, Hong Kong.
    2
    State Key Laboratory of Liver Research, The University of Hong Kong, Pok Fu Lam, Hong Kong.
    3
    Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
    4
    Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam Road 102,, Pok Fu Lam, Hong Kong. [email protected].
    5
    State Key Laboratory of Liver Research, The University of Hong Kong, Pok Fu Lam, Hong Kong. [email protected].

    PMID: 33731023 DOI: 10.1186/s12876-021-01711-x

Abstract

Background: Serum hepatitis B core-related antigen (HBcrAg) is a potential surrogate marker for intra-hepatic covalently-closed circular DNA in chronic hepatitis B (CHB). We aimed to study the profiles of serum HBcrAg in CHB patients treated with first-line nucleos(t)ide analogues (NA): entecavir (ETV), tenofovir disoproxil fumarate (TDF) or tenofovir alafenamide (TAF).

Method: Serum HBcrAg was measured in 120 treatment-naïve CHB patients receiving one of the 3 NAs (ETV: TDF: TAF = 60: 26: 34) using the Lumipulse G HBcrAg assay in a Lumipulse G1200 analyzer (Fujirebio Inc, Toyko, Japan). Serum HBcrAg levels were measured at week 0, week 48 and week 96 of NA therapy.

Results: Among the 120 patients, 67 (55.8%) were hepatitis B e antigen (HBeAg) positive. Both tenofovir and ETV led to significantly lower serum HBcrAg at week 48 and week 96 compared to week 0. There were no significant differences for the magnitude of median HBcrAg decline at week 96 between tenofovir and ETV in HBeAg-positive (2.28 vs. 1.65 log U/mL, p > 0.05) and HBeAg-negative (0.83 vs. 0.54 log U/mL, p > 0.05) patients. TDF and TAF produced no significant differences in the magnitude of median HBcrAg decline at week 96 (HBeAg-positive: 2.63 vs. 1.83, respectively; HBeAg-negative: 1.04 vs. 0.40, respectively; both p > 0.05).

Conclusion: Magnitude of reduction of HBcrAg levels after 2-year first-line treatment did not differ statistically among the current first-line NAs, although HBcrAg reduction was numerically greater in tenofovir-treated group. More long-term studies are essential to determine whether tenofovir exerts a more pronounced effect on HBcrAg.

Keywords: Entecavir; Hepatitis B; Hepatitis B core-related antigen; Nucleotide analogue; Tenofovir.

StephenW

一线口服抗病毒治疗对慢性乙型肝炎患者的血清HBcrAg抑制作用相似
麦龙怡1 2，黄家豪1 2，张家成1 3，惠威濑户1 2，冯德伦1 2，袁文峰4 5
隶属关系
隶属关系

    1个
    香港大学薄扶林道102号香港大学玛丽医院医学系
    2个
    香港大学，香港薄扶林，肝病研究国家重点实验室。
    3
    香港大学深圳大学医学部，深圳
    4
    香港大学薄扶林道102号香港大学玛丽医院医学系[email protected]。
    5
    香港大学，香港薄扶林，肝病研究国家重点实验室。 [email protected]。

    PMID：33731023 DOI：10.1186 / s12876-021-01711-x

抽象的

背景：血清乙型肝炎核心相关抗原（HBcrAg）是慢性乙型肝炎（CHB）中肝内共价闭合环状DNA的潜在替代标志物。我们的目的是研究用一线核苷酸（t）类似物（NA）治疗的CHB患者的血清HBcrAg的特征：恩替卡韦（ETV），替诺福韦二富马酸富马酸酯（TDF）或替诺福韦阿拉芬酰胺（TAF）。

方法：在Lumipulse G1200分析仪（Fujirebio Inc，Toyko，日本）中，使用Lumipulse G HBcrAg测定法对120名接受过3种NA之一的初治CHB患者（ETV：TDF：TAF = 60：26：34）进行了血清HBcrAg测定。 ）。在NA治疗的第0周，第48周和第96周测量血清HBcrAg水平。

结果：在120例患者中，有67例（55.8％）的乙肝e抗原（HBeAg）阳性。与第0周相比，替诺福韦和ETV在第48周和第96周时均导致血清HBcrAg显着降低。替诺福韦和ETV在HBeAg阳性时，第96周时HBcrAg中位数下降幅度无明显差异（2.28 vs. 1.65 log U / mL，p> 0.05）和HBeAg阴性（0.83 vs. 0.54 log U / mL，p> 0.05）患者。 TDF和TAF在第96周时的HBcrAg中位数下降幅度没有显着差异（HBeAg阳性：分别为2.63和1.83； HBeAg阴性：分别为1.04和0.40；两者均p> 0.05）。

结论：尽管一剂替诺福韦治疗组的HBcrAg降低在数值上更大，但当前一线NAs在2年一线治疗后降低HBcrAg水平的幅度无统计学差异。长期的研究对于确定替诺福韦是否对HBcrAg发挥更明显的作用至关重要。

关键字：恩替卡韦；乙型肝炎；乙肝核心相关抗原；核苷酸类似物；替诺福韦。

StephenW

https://bmcgastroenterol.biomedc ... 876-021-01711-x.pdf