恩替卡韦或富马酸替诺福韦二吡呋酯治疗慢性乙型肝炎期间

StephenW

恩替卡韦或富马酸替诺福韦二吡呋酯治疗慢性乙型肝炎期间功能治愈的发生率和决定因素
Yao-Cun Hsu、Ming-Lun Yeh、Grace Lai-Hung Wong、Chien-Hung Chen、 Cheng-Yuan Peng、Maria Buti、Masaru Enomoto、Qing Xie、Huy Trinh、Carmen Preda ... 显示更多
传染病杂志，第 224 卷，第 11 期，2021 年 12 月 1 日，第 1890-1899 页，https://doi.org/10.1093/infdis/jiab241
发表：
2021 年 5 月 17 日
文章历史

    引用
    权限图标权限
    分享

抽象的
背景

恩替卡韦 (ETV) 或富马酸替诺福韦酯 (TDF) 治疗期间功能性治愈（乙型肝炎表面抗原 [HBsAg] 血清清除）的长期发病率和基线决定因素尚不完全清楚。
方法

这是一项国际多中心队列研究，针对未接受过治疗的慢性乙型肝炎患者开始 ETV 或 TDF 治疗，但没有基线癌症。观察患者的 HBsAg 血清清除率，直至死亡或失访。我们计算了发病率并使用竞争风险回归探索了 HBsAg 血清清除的基线决定因素。
结果

分析包括 4769 名患者（中位年龄，50 岁；69.05% 为男性），中位随访时间为 5.16 年（26614.47 人年）。 58 名患者发生 HBsAg 清除，10 年累积发生率为 2.11%（95% 置信区间，1.54%–2.88%），年发生率为 0.22%（.17%–.28​​%）。基线预测因素包括乙型肝炎病毒 DNA <2000 IU/mL 的低水平病毒血症（调整后的亚分布风险比，3.14 [95% 置信区间，1.80–5.49]），血清丙氨酸转氨酶升高 >200 U/L（3.68 [2.07– 6.53]）、血清胆红素（1.11/mg/dL；[1.06–1.17 mg/dL]）和脂肪肝（1.84 [1.03–3.29]）。
结论

HBsAg 血清清除很少发生在接受 ETV 或 TDF 治疗的慢性乙型肝炎患者中，并且与低水平病毒血症、丙氨酸转氨酶升高、胆红素水平和脂肪肝有关。

在一线口服抗病毒治疗期间，乙肝病毒感染的功能性治愈很少发生，平均年增长率为 0.22%，在低水平病毒血症、高水平转氨酶升高、血清胆红素升高和脂肪肝患者中观察到的机会更高。肝脏。
乙肝病毒，功能性治愈，恩替卡韦，替诺福韦，乙肝表面抗原，REAL-B
话题：

    胆红素 脂肪肝 随访 乙型肝炎表面抗原 乙型肝炎、慢性乙型肝炎病毒 dna 乙型肝炎病毒 替诺福韦 恩替卡韦

StephenW

Incidences and Determinants of Functional Cure During Entecavir or Tenofovir Disoproxil Fumarate for Chronic Hepatitis B
Yao-Chun Hsu, Ming-Lun Yeh, Grace Lai-Hung Wong, Chien-Hung Chen, Cheng-Yuan Peng, Maria Buti, Masaru Enomoto, Qing Xie, Huy Trinh, Carmen Preda ... Show more
The Journal of Infectious Diseases, Volume 224, Issue 11, 1 December 2021, Pages 1890–1899, https://doi.org/10.1093/infdis/jiab241
Published:
17 May 2021
Article history

    Cite
    Permissions Icon Permissions
    Share

Abstract
Background

Long-term incidences and baseline determinants of functional cure (hepatitis B surface antigen [HBsAg] seroclearance) during entecavir (ETV) or tenofovir disoproxil fumarate (TDF) treatment are incompletely understood.
Methods

This is an international multicenter cohort study of treatment-naive patients with chronic hepatitis B who started ETV or TDF treatment without baseline cancer. Patients were observed for HBsAg seroclearance until death or loss to follow-up. We calculated the incidences and explored the baseline determinants of HBsAg seroclearance using competing risk regression.
Results

The analysis included 4769 patients (median age, 50 years; 69.05% male), with a median follow-up of 5.16 years (26 614.47 person-years). HBsAg clearance occurred in 58 patients, yielding a 10-year cumulative incidence of 2.11% (95% confidence interval, 1.54%–2.88%) and an annual rate of 0.22% (.17%–.28%). Baseline predictors included low-level viremia with hepatitis B virus DNA <2000 IU/mL (adjusted subdistribution hazard ratio, 3.14 [95% confidence interval, 1.80–5.49]), elevated serum alanine aminotransferase >200 U/L (3.68 [2.07–6.53]), serum bilirubin (1.11 per mg/dL; [1.06–1.17 mg/dL]), and fatty liver (1.84 [1.03–3.29]).
Conclusion

HBsAg seroclearance rarely occurs in patients with chronic hepatitis B treated with ETV or TDF and is associated with low-level viremia, alanine aminotransferase flare, bilirubin level, and fatty liver.

Functional cure of hepatitis B virus infection rarely occurred at an average annual rate of 0.22% during first-line oral antiviral treatment, with higher chances observed in patients with low-level viremia, high-level aminotransferase flare, elevation of serum bilirubin, and fatty liver.
hepatitis B virus, functional cure, entecavir, tenofovir, hepatitis B surface antigens, REAL-B
Topic:

    bilirubin fatty liver follow-up hepatitis b surface antigens hepatitis b, chronic hepatitis b virus dna hepatitis b virus tenofovir entecavir