病毒学复发但临床未复发的患者停用恩替卡韦或替诺福韦后 H

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病毒学复发但临床未复发的患者停用恩替卡韦或替诺福韦后 HBsAg 的动力学
曾子宁 1 , 郭元洪 1 , 胡宗慧 1 , 洪超红 1 , 王景红 1 , 卢盛南 1 , 陈建红 1
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    1
    台湾高雄 833 长庚大学医学院高雄长庚纪念医院内科肝肠内科

    PMID：35746660 DOI：10.3390/v14061189

抽象的

本研究调查了在病毒学复发后实现病毒学抑制且无临床复发的慢性乙型肝炎 (CHB) 患者停用恩替卡韦或富马酸替诺福韦二吡呋酯 (TDF) 后 HBsAg 的动力学和 HBsAg 消失率。共纳入 504 名 HBeAg 阴性、非肝硬化患者，这些患者既往接受过恩替卡韦或 TDF 治疗后接受过至少 30 个月的随访。在 504 名患者中，128 名实现了持续的病毒学抑制（I 组），81 名经历了病毒学复发而没有临床复发。在 81 名患者中，52 名有间歇性或持续性 HBV DNA > 2000 IU/mL（第 II 组）和 29 人在病毒学复发后至少 1.5 年（第 III 组）实现了持续的病毒学抑制（HBV DNA < 2000 IU/mL）。广义估计方程分析表明，第 I 组和第 III 组经历了比第 II 组更大的治疗后 HBsAg 下降（两者，p < 0.001）。第 I 组和第 III 组的治疗后 HBsAg 下降相似（p = 0.414）。多变量分析表明，第一组和第三组之间的 HBsAg 变化和 HBsAg 下降（分别为 p = 0.920 和 0.886）或 HBsAg 消失率（p = 0.192）没有差异。在 HBV 复发后实现持续病毒抑制且无临床复发的患者，其 HBsAg 下降和 HBsAg 消失率与持续应答者相似。

关键词：HBsAg；恩替卡韦；广义估计方程；替诺福韦。
赠款支持

    NMRPG8G6102/科技部
    CMRPG8F0221/长庚纪念医院

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Kinetics in HBsAg after Stopping Entecavir or Tenofovir in Patients with Virological Relapse but Not Clinical Relapse
Tzu-Ning Tseng  1 , Yuan-Hung Kuo  1 , Tsung-Hui Hu  1 , Chao-Hung Hung  1 , Jing-Houng Wang  1 , Sheng-Nan Lu  1 , Chien-Hung Chen  1
Affiliations
Affiliation

    1
    Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.

    PMID: 35746660 DOI: 10.3390/v14061189

Abstract

This study investigated the kinetics in HBsAg and the HBsAg loss rate after entecavir or tenofovir disoproxil fumarate (TDF) cessation in patients with chronic hepatitis B (CHB) who achieved virological suppression after virological relapse without clinical relapse. A total 504 HBeAg-negative, non-cirrhotic patients who previously received entecavir or TDF with post-treatment and who were followed up for at least 30 months were included. Of the 504 patients, 128 achieved sustained virological suppression (Group I), and 81 experienced virological relapse without clinical relapse. Of the 81 patients, 52 had intermittent or persistent HBV DNA &gt; 2000 IU/mL (Group II), and 29 achieved persistent virological suppression (HBV DNA &lt; 2000 IU/mL) for at least 1.5 years (Group III) after virological relapse. A generalized estimating equations analysis showed that Groups I and III experienced larger off-treatment HBsAg declines than Group II (both, p &lt; 0.001). The post-treatment HBsAg declines of Group I and Group III were similar (p = 0.414). A multivariate analysis showed that there were no differences in the HBsAg change and HBsAg decline (p = 0.920 and 0.886, respectively) or HBsAg loss rate (p = 0.192) between Group I and Group III. The patients who achieved persistent viral suppression after HBV relapse without clinical relapse have a similar decline in HBsAg and the HBsAg loss rate as the sustained responders.

Keywords: HBsAg; entecavir; generalized estimating equations; tenofovir.
Grant support

    NMRPG8G6102/Ministry of Science and Technology
    CMRPG8F0221/Chang Gung Memorial Hospital

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https://www.mdpi.com/1999-4915/14/6/1189/pdf?version=1654151133