接受恩替卡韦治疗的慢性乙型肝炎患者中与 HBeAg 血清学转换

StephenW

接受恩替卡韦治疗的慢性乙型肝炎患者中与 HBeAg 血清学转换和双阴性 HBV DNA 和 RNA 相关的 HBV RNA 下降：一项 10 年回顾性队列研究
冯烨#1、赵文娟#1、杨学良1、张希1、小翠安1、朱瑞雪1、陈云茹1、刘晓静1、李建洲1、康李1、郑洁1、林淑梅1、雷石 1
隶属关系
联系

    1
    【作者单位】： 西安交通大学第一附属医院感染科;

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同等贡献。

    PMID：36110993 PMCID：PMC9469125 DOI：10.21037/atm-22-3265

抽象的

背景：在接受长期核苷（酸）类似物（NAs）治疗的慢性乙型肝炎（CHB）患者中，乙型肝炎病毒（HBV）RNA的下降是否与抗病毒效果相关仍不清楚。我们观察了接受恩替卡韦 (ETV) 治疗 10 年的 CHB 患者的血清 HBV RNA 水平，并探讨了 HBV RNA 在长期抗病毒治疗中的临床意义。

方法：本研究共招募了 33 名接受 ETV 治疗长达 10 年的乙型肝炎表面抗原 (HBsAg) 阳性 CHB 患者。在基线和每个随访点测量肝功能、HBsAg、乙型肝炎包膜抗原 (HBeAg)、HBV DNA 和 HBV RNA。抗病毒效力定义为阴性 HBV DNA (<20 IU/mL) 和 HBV RNA (<300 Copies/mL)。

结果：（一）血清HBV DNA和HBV RNA随着抗病毒治疗10年的持续时间而下降（P<0.001）。 （二）各随访点血清HBV DNA与HBV RNA呈正相关（基线时r=0.62和P<0.001，第24周时r=0.77和P<0.001，时点r=0.71和P<0.001）第 48 周，第 96 周 r=0.81 和 P<0.001，第 5 年 r=0.60 和 P<0.01，第 10 年 r=0.77 和 P<0.001）。 (三) ETV治疗后基线和第10年HBeAg和HBsAg水平有显着性差异(P<0.05和P<0.01)。 （四）ETV治疗后HBV RNA下降与HBeAg血清学转换相关，基线时HBV RNA下降的ROC曲线下面积（AUROCs）为0.25，第24周为0.62，第48周为0.78，第48周为0.86分别为第 96 周。 (V) ETV治疗后HBV RNA下降与抗病毒疗效相关，HBV RNA下降的AUROCs分别为基线0.33、第24周0.74、第48周0.83和第96周0.86。

结论：血清 HBV DNA 和 HBV RNA 随着抗病毒治疗持续时间超过 10 年而下降。在接受长期 ETV 治疗的 CHB 患者中，HBV RNA 的下降与 HBeAg 血清学转换和抗病毒疗效有关，最早的预测点是第 24 周。

关键词：慢性乙型肝炎（CHB）；乙肝病毒DNA；乙肝病毒核糖核酸；抗病毒治疗；乙型肝炎包膜抗原 (HBeAg) 血清转换。

2022 年转化医学年鉴。版权所有。
利益冲突声明

利益冲突：所有作者均已填写 ICMJE 统一披露表（可在 https://atm.amegroups.com/article/view/10.21037/atm-22-3265/coif 获得）。作者没有需要声明的利益冲突。

StephenW

The decline of HBV RNA associated with HBeAg seroconversion and double-negative HBV DNA and RNA in chronic hepatitis B patients who received entecavir therapy: a 10-year retrospective cohort study
Feng Ye #  1 , Wenjuan Zhao #  1 , Xueliang Yang  1 , Xi Zhang  1 , Xiaocui An  1 , Ruixue Zhu  1 , Yunru Chen  1 , Xiaojing Liu  1 , Jianzhou Li  1 , Kang Li  1 , Jie Zheng  1 , Shumei Lin  1 , Lei Shi  1
Affiliations
Affiliation

    1
    Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

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Contributed equally.

    PMID: 36110993 PMCID: PMC9469125 DOI: 10.21037/atm-22-3265

Abstract

Background: Whether the decline of hepatitis B virus (HBV) RNA was associated with antiviral efficacy in chronic hepatitis B (CHB) patients receiving long-term nucleos(t)ide analogues (NAs) therapy remains unclear. We observed the levels of serum HBV RNA in CHB patients treated with entecavir (ETV) for 10 years and explored the clinical significance of HBV RNA during long-term antiviral treatment.

Methods: A total of 33 hepatitis B surface antigen (HBsAg)-positive CHB patients treated with ETV for up to 10 years were recruited for this study. Liver function, HBsAg, hepatitis B envelope antigen (HBeAg), HBV DNA, and HBV RNA were measured at the baseline and each follow-up points. Antiviral efficacy was defined as negative HBV DNA (<20 IU/mL) and HBV RNA (<300 Copies/mL).

Results: (I) Serum HBV DNA and HBV RNA declined with the duration of antiviral treatment over 10 years (P<0.001). (II) There were positive correlations between serum HBV DNA and HBV RNA at each follow-up point (r=0.62 and P<0.001 at baseline, r=0.77 and P<0.001 at week 24, r=0.71 and P<0.001 at week 48, r=0.81 and P<0.001 at week 96, r=0.60 and P<0.01 at year 5 and r=0.77 and P<0.001 at year 10). (III) HBeAg and HBsAg levels at baseline and 10th year after ETV treatment have significant difference (P<0.05 and P<0.01). (IV) The decline of HBV RNA after ETV treatment was associated with HBeAg seroconversion, the area under the ROC curves (AUROCs) of the declines of HBV RNA were 0.25 at the baseline, 0.62 at week 24, 0.78 at week 48 and 0.86 at week 96, respectively. (V) The decline of HBV RNA after ETV treatment was associated with antiviral efficacy, the AUROCs of the declines of HBV RNA were 0.33 at the baseline, 0.74 at week 24, 0.83 at week 48 and 0.86 at week 96, respectively.

Conclusions: Serum HBV DNA and HBV RNA declined with the duration of antiviral treatment over 10 years. The decline of HBV RNA was associated with HBeAg seroconversion and antiviral efficacy in CHB patients receiving long-term ETV therapy, and the earliest prediction point was week 24.

Keywords: Chronic hepatitis B (CHB); HBV DNA; HBV RNA; antiviral treatment; hepatitis B envelope antigen (HBeAg) seroconversion.

2022 Annals of Translational Medicine. All rights reserved.
Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://atm.amegroups.com/article/view/10.21037/atm-22-3265/coif). The authors have no conflicts of interest to declare.

StephenW

https://atm.amegroups.com/article/viewFile/100396/pdf