Sustained Responses and Loss of HBsAg in HBeAg-Negative Patients With Chronic Hepatitis B Who Stop Long-Term Treatment With Adefovir
Sustained Responses and Loss of HBsAg in HBeAg-Negative Patients With Chronic Hepatitis B Who Stop Long-Term Treatment With Adefovir
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DOI：
10.1053/j.gastro.2012.05.039
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发表时间：
2012-09-01
期刊：
影响因子：
29.4
通讯作者：
Hadziyannis, Emilia
中科院分区：
文献类型：
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作者：
Hadziyannis, Stephanos J.;Sevastianos, Vassilios;Hadziyannis, Emilia
背景与目的：对于B肝炎e抗原（HBeAg）阴性的慢性B肝炎（CHB）患者停止长期核苷（酸）类似物治疗的生化和病毒学影响知之甚少。方法：我们进行了一项队列观察研究，随访33例HBeAg阴性的慢性乙型肝炎患者，血清HBV DNA检测不到，长期（4或5年）接受阿德福韦酯（ADV）治疗后转氨酶水平正常。所有患者随访5.5年;随访包括前6个月每月测量血清丙氨酸氨基转移酶（ALT）、B型肝炎表面抗原（HBsAg）和HBV DNA，此后每3-6个月进行一次。在基线、治疗结束（EOT）和治疗后测量各种因素，以确定与HBsAg清除相关的因素。结果：在停药后的最初几个月，所有患者均发生病毒学复发，25例（76%）发生生化复发。在随访期间，18例（55%）停止抗病毒治疗的患者获得了持续应答（HBV DNA水平
BACKGROUND & AIMS: Little is known about the biochemical and virological effects of stopping long-term nucleos(t)ide analogue therapy for hepatitis B e antigen (HBeAg)-negative patients with chronic hepatitis B (CHB). METHODS: We performed a cohort observational study, following 33 HBeAg-negative patients with CHB, undetectable serum HBV DNA, and normal levels of amino-transferases after long-term (4 or 5 years) treatment with adefovir dipivoxil (ADV). All patients were followed for 5.5 years; follow-up visits included measurements of serum alanine aminotransferase (ALT), hepatitis B surface antigen (HBsAg), and HBV DNA monthly for the first 6 months and every 3-6 months thereafter. Various factors were measured at baseline, the end of treatment (EOT), and following treatment to identify those associated with clearance of HBsAg. RESULTS: During the first few months of the postdiscontinuation period, all patients experienced virological and 25 (76%) had biochemical relapse. During the follow-up period, 18 patients (55%) who had discontinued antiviral therapy achieved sustained response (HBV DNA level