Reduced risk of relapse after long-term nucleos(t)ide analogue consolidation therapy for chronic hepatitis B
Reduced risk of relapse after long-term nucleos(t)ide analogue consolidation therapy for chronic hepatitis B
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DOI：
10.1111/apt.13150
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发表时间：
2015-05-01
影响因子：
7.6
通讯作者：
Janssen, H. L. A.
中科院分区：
文献类型：
--
作者：
Chi, H.;Hansen, B. E.;Janssen, H. L. A.
在慢性B型肝炎（CH B）患者停止核苷（酸）类似物（NA）治疗前，建议进行6- 12个月的巩固治疗，目的探讨巩固治疗对CH B患者停药结局的影响。患者在治疗开始时可能是HBeAg阳性或HBeAg阴性，但在停药时是HBeAg阴性且HBV DNA检测不到。巩固治疗定义为在首次检测不到HBV DNA后进行治疗结果3年后，74%的HBeAg阳性患者和75%的HBeAg阴性患者在同一时间点HBV DNA > 2000 IU/mL，而持续性病毒学复发（1年内2次检测HBV DNA > 2000 IU/mL，间隔6个月）发生在49%的治疗开始时HBeAg阳性和53%的治疗开始时HBeAg阴性患者。对于HBeAg阳性和HBeAg阴性的患者，巩固治疗3年与较低的持续病毒学复发率相关，
BackgroundBefore stopping nucleos(t)ide analogue (NA) treatment in chronic hepatitis B (CHB), 6-12months of consolidation therapy is recommended.AimTo investigate the effect of consolidation therapy on off-treatment outcomes in CHB patients.MethodsWe included 94 patients who stopped NA after at least 1year of therapy. Patients could be HBeAg-positive or HBeAg-negative at start-of-treatment, but were HBeAg-negative and had undetectable HBV DNA at time of discontinuation. Consolidation therapy was defined as treatment after the first undetectable HBV DNA (and HBeAg loss for HBeAg-positive patients) until NA cessation.ResultsAt 3years, 74% of the start-of-treatment HBeAg-positive and 75% of the start-of-treatment HBeAg-negative patients developed HBV DNA >2000IU/mL at a single time point, whereas a persistent virological relapse (2 tests of HBV DNA >2000IU/mL 6months apart within 1year) developed in 49% of the start-of-treatment HBeAg-positive and 53% of the start-of-treatment HBeAg-negative patients. For both HBeAg-positive and HBeAg-negative patients, consolidation therapy of 3years was associated with lower persistent virological relapse rates compared to