Predictors early HBeAg loss during lamivudine therapy in eAg+ with acute exacerb

StephenW

<http://www.springerlink.com/content/2278v71443807h43/>

Hepatology International
DOI: 10.1007/s12072-010-9227-xOnline First¢â

Original Article
Predictors for early HBeAg loss during lamivudine therapy in HBeAg-positive
chronic hepatitis B patients with acute exacerbation

Cheng-Yuan Peng, Chih-Bin Chen, Hsueh-Chou Lai, Wen-Pang Su, Po-Heng Chuang,
Hong-Dar Isaac Wu and Long-Bin Jeng

Abstract

Purpose  
To examine the rate of early HBeAg loss and predictors of HBeAg loss in
HBeAg-positive chronic hepatitis B (CHB) patients with acute exacerbation (AE)
treated with lamivudine.

Methods  
A total of 146 patients diagnosed with CHB and AEs were included in this
retrospective study. Patients were divided into two groups: decompensated and
compensated.

Results  
The mean treatment duration for the decompensated and compensated groups was
18.1 and 19.9 months, respectively. Decompensated patients were significantly
older and had a higher prevalence of cirrhosis and genotype B infection than
compensated patients. Compared to compensated patients, decompensated patients
achieved a higher rate of HBeAg loss (25.8 vs. 14.3%; P = 0.0805) at 3 months of
therapy, a higher rate of serum HBV DNA negativity (53.2 vs. 29.8%; P = 0.0042),
and a lower rate of rtM204V/I mutation (3.2 vs. 16.7%; P = 0.0139) after 12
months of lamivudine therapy. The rates of HBeAg loss after 6 and 12 months of
lamivudine therapy were similar between the two groups. Logistic regression
analysis revealed that female gender and baseline ALT level ¡Ã1,000 IU/L, but
not decompensations, were significant predictors of HBeAg loss at 3 months;
however, only female gender was a significant predictor of HBeAg loss after 6
and 12 months of lamivudine therapy. The early HBeAg losers showed a
significantly higher sustained remission rate off lamivudine therapy.

Conclusions  
Female gender and baseline serum ALT level ¡Ã1,000 IU/L were independent
predictors of early HBeAg loss during lamivudine therapy in HBeAg-positive CHB
patients with AE.

国际肝病学
分类号：10.1007/s12072-010-9227-xOnline第一¢ â

原创文章
HBeAg转阴早期预测拉米夫定治疗过程中的e抗原阳性
慢性乙型肝炎急性发作患者

彭成元，智彬陈，雪州赖文逄素，宝恒庄
宏达艾萨克吴长郑隆宾

摘要

目的
为了探讨早期HBeAg阴转率和HBeAg的损失预测
e抗原阳性慢性乙型肝炎（CHB）患者急性发作期（自动曝光）
拉米夫定治疗。

方法
慢性乙型肝炎的诊断和不良事件共146例纳入本
回顾性研究。患者分为两组：失代偿期和
补偿。

结果
对于失代偿和补偿组平均治疗时间为
18.1和19.9个月。失代偿期患者显着
老年人和有肝硬化和B基因型感染的发病率较高比
补偿患者。补偿患者相比，失代偿患者
实现了HBeAg转阴率较高（25.8对比14.3％，P值0.0805），在3个月
疗法，血清HBV DNA阴转率较高（53.2对比29.8％，P值0.0042），
和更低的速率rtM204V /我的突变（3.2主场迎战16.7％，P值0.0139）后12
个月的拉米夫定治疗。 HBeAg转阴后的6至12个月，利率
拉米夫定治疗相似，两组间。 Logistic回归
分析显示，女性性别和基线ALT水平¡ A1和000国际单位/ L，而
不decompensations，分别在3个月的HBeAg重大损失的预测;
然而，唯一的女性性别是一个重要的预测后HBeAg转阴6
拉米夫定治疗12个月。早期e抗原呈失败者
显着高于拉米夫定治疗持续了缓解率。

结论
女性性别和基线血清ALT水平¡格A1，000国际单位/ L的独立
早期预测过程中HBeAg阴转HBeAg阳性慢性乙型肝炎拉米夫定治疗
患者与AE。




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