结合基线 HBcrAg 和治疗结束时 HBsAg 预测恩替卡韦或替诺福韦

StephenW

结合基线 HBcrAg 和治疗结束时 HBsAg 预测恩替卡韦或替诺福韦停药后 HBV 复发
Tzu-Ning Tseng 1 , Wen-Juei Jeng 2 , Tsung-Hui Hu 1 , Jing-Houng Wang 1 , Chao-Hung Hung 1 , Sheng-Nan Lu 1 , Chien-Hung Chen 1
隶属关系
隶属关系

     1个
     台湾高雄长庚大学医学院高雄长庚医院内科肝肠胃科。
     2个
     台湾桃园长庚大学医学院林口长庚纪念医院内科肝胃肠科。

     PMID：36478233 DOI：10.1093/jac/dkac409

抽象的

背景：对于慢性乙型肝炎 (CHB) 患者，恩替卡韦或富马酸替诺福韦二吡呋酯治疗的最佳停止标准仍不清楚。

方法：本研究招募来自高雄（n = 190）和林口（n = 188）长庚纪念医院治疗结束时（EOT）乙型肝炎表面抗原（HBsAg）水平<100 IU / mL的慢性乙型肝炎患者供使用 分别作为开发组和验证组。

结果：在开发组中，108 名 HBsAg ≤40 IU/mL 的患者用于分析 HBV 复发和 HBsAg 消失的预测因子。 多变量分析表明，年龄、核苷（酸）类似物 (NA) 经历状态、基线乙型肝炎核心相关抗原 (HBcrAg) 和 EOT 时的 HBsAg 与病毒学和临床复发独立相关。 EOT 时 HBsAg 水平为 20 IU/mL 是最小化 HBV 复发的最佳临界值。 在开发组和验证组中，与 EOT HBsAg 21-40 IU/mL 和 HBsAg 41-100 IU/mL 的患者相比，EOT HBsAg ≤20 IU/mL 的患者病毒学和临床复发率更低，HBsAg 消失率更高。 基线 HBcrAg ≤ 4 log 的患者的病毒学和临床复发率非常低（5 年率：分别为 6.5% 和 0%），HBsAg 消失率非常高（5 年率：81.7%） 开发组U/mL和EOT HBsAg≤20 IU/mL。

结论：基线 HBcrAg ≤ 4 log U/mL 和 EOT HBsAg 水平 ≤ 20 IU/mL 的组合可能会降低 HBV 复发风险并增加 HBsAg 消失率，并可能有助于非 NA 随访策略。

© The Author(s) 2022. 由牛津大学出版社代表英国抗微生物化疗学会出版。 版权所有。 如需许可，请发送电子邮件至：[email protected]。
拨款支持

     CMRPG8I0211/科技部
     长庚纪念医院

StephenW

Combined baseline HBcrAg and end-of-treatment HBsAg predict HBV relapse after entecavir or tenofovir cessation
Tzu-Ning Tseng  1 , Wen-Juei Jeng  2 , Tsung-Hui Hu  1 , Jing-Houng Wang  1 , Chao-Hung Hung  1 , Sheng-Nan Lu  1 , Chien-Hung Chen  1
Affiliations
Affiliations

    1
    Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
    2
    Division of Hepatogastroenterology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.

    PMID: 36478233 DOI: 10.1093/jac/dkac409

Abstract

Background: For patients with chronic hepatitis B (CHB), the optimal stopping criteria for entecavir or tenofovir disoproxil fumarate treatment remain unclear.

Methods: This study recruited CHB patients with levels of hepatitis B surface antigen (HBsAg) <100 IU/mL at the end of treatment (EOT) from Kaohsiung (n = 190) and Linkou (n = 188) Chang Gung Memorial Hospitals for use as development and validation groups, respectively.

Results: In the development group, 108 patients with HBsAg ≤40 IU/mL were used for analysis of predictors of HBV relapse and HBsAg loss. Multivariate analysis showed that age, nucleos(t)ide analogue (NA)-experienced status, baseline hepatitis B core-related antigen (HBcrAg) and HBsAg at EOT were associated independently with virological and clinical relapse. An HBsAg level of 20 IU/mL at EOT was the best cut-off value for minimizing HBV relapse. Patients with EOT HBsAg ≤20 IU/mL had lower virological and clinical relapse rates and higher HBsAg loss rates than those with EOT HBsAg 21-40 IU/mL and HBsAg 41-100 IU/mL in the development and validation groups. The virological and clinical relapse rates were very low (5-year rates: 6.5% and 0%, respectively) and HBsAg loss rate was very high (5-year rate: 81.7%) in patients with a combination of baseline HBcrAg ≤4 log U/mL and EOT HBsAg ≤20 IU/mL in the development group.

Conclusions: A combination of baseline HBcrAg ≤4 log U/mL and EOT HBsAg level ≤20 IU/mL might reduce the risk of HBV relapse and increase HBsAg loss rate, and might be helpful for off-NA follow-up strategy.

© The Author(s) 2022. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please e-mail: [email protected].
Grant support

    CMRPG8I0211/Ministry of Science and Technology
    Chang Gung Memorial Hospital