乙型肝炎e抗原阴性患者中恩替卡韦停止后乙型肝炎病毒核心

StephenW

The role of hepatitis B virus core-related antigen in predicting hepatitis B virus relapse after cessation of entecavir in hepatitis B e antigen-negative patients
Pao-Yuan Huang  1 , Jing-Houng Wang  1 , Chao-Hung Hung  1 , Sheng-Nan Lu  1 , Tsung-Hui Hu  1 , Chen Chien-Hung  1
Affiliations
Affiliation

    1
    Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.

    PMID: 33932245 DOI: 10.1111/jvh.13528

Abstract

This study investigated the ability of hepatitis B core related antigen (HBcrAg) to predict hepatitis B virus (HBV) relapse in HBeAg-negative patients after cessation of entecavir therapy. A total of 301 HBeAg-negative patients without cirrhosis who had stopped entecavir therapy for at least 12 months were recruited. All patients fulfilled the stopping criteria proposed by the APASL 2012 guidelines. The five-year cumulative rates of virological relapse, clinical relapse, and HBsAg loss were 71.6%, 57.3%, and 18.7%, respectively. Serum HBsAg at end-of-treatment (EOT) was an independent predictor of virological relapse, clinical relapse and HBsAg loss; an EOT HBsAg of 150 IU/mL was the optimal cutoff value. The 5-year virological relapse rates for patients with <150 and ≥150 IU/mL HBsAg at EOT were 43.3% and 82.2% (P<.001), clinical relapse rates were 32.3% and 66.3% (P<.001), and HBsAg loss rates were 46.1% and 5.2% (P<.001), respectively. A baseline HBcrAg of 4 IU/mL was the optimal cutoff value for predicting HBV relapse. Among patients with an EOT HBsAg <150 IU/mL, the five-year virological relapse rates for patients with baseline HBcrAg levels ≤4 and >4 log U/mL were 27.9% and 59.1% (P=.006) and the clinical relapse rates were 18% and 48.1% (P=.014), respectively. EOT HBcrAg was not a significant predictor of virological or clinical relapse after cessation of entecavir. In conclusion, the combination of an EOT HBsAg of 150 IU/mL and baseline HBcrAg of 4 log U/mL can effectively predict the risk of HBV relapse after stopping entecavir therapy.

Keywords: Hepatitis B surface antigen; entecavir; hepatitis B core related antigen; hepatitis B virus; relapse.

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StephenW

乙型肝炎e抗原阴性患者中恩替卡韦停止后乙型肝炎病毒核心相关抗原在预测乙型肝炎病毒复发中的作用
黄宝元1，王静雄1，洪朝雄1，卢圣男1，胡宗辉1，陈建雄1
隶属关系
联系

    1个
    台湾长庚大学医学院高雄市长庚纪念医院内科肝消化肠内科，台湾高雄。

    PMID：33932245 DOI：10.1111 / jvh.13528

抽象的

这项研究调查了在停止恩替卡韦治疗后，HBeAg阴性患者的乙型肝炎核心相关抗原（HBcrAg）预测乙型肝炎病毒（HBV）复发的能力。总共招募了停止恩替卡韦治疗至少12个月的301例无肝硬化的HBeAg阴性患者。所有患者均符合APASL 2012指南提出的停止标准。五年病毒学复发，临床复发和HBsAg丢失的累积率分别为71.6％，57.3％和18.7％。治疗结束时血清HBsAg（EOT）是病毒学复发，临床复发和HBsAg丢失的独立预测因子。 150 IU / mL的EOT HBsAg是最佳临界值。 HBsAg <150和≥150IU / mL的患者在EOT时的5年病毒学复发率分别为43.3％和82.2％（P <.001），临床复发率分别为32.3％和66.3％（P <.001），和HBsAg丢失率分别为46.1％和5.2％（P <.001）。基线HBcrAg为4 IU / mL是预测HBV复发的最佳临界值。在EOT HBsAg <150 IU / mL的患者中，基线HBcrAg水平≤4和> 4 log U / mL的患者的五年病毒学复发率分别为27.9％和59.1％（P = .006）发生率分别为18％和48.1％（P = .014）。恩替卡韦停药后，EOT HBcrAg并不是病毒学或临床复发的重要预测指标。总之，将EOT HBsAg为150 IU / mL和基线HBcrAg为4 log U / mL可以有效预测停止恩替卡韦治疗后HBV复发的风险。

关键词：乙型肝炎表面抗原恩替卡韦乙肝核心相关抗原；乙型肝炎病毒;复发。

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