Dynamic Characteristics of Serum Hepatitis B Surface Antigen in Chinese Chronic Hepatitis B Patients Receiving 7 Years of Entecavir Therapy.
Dynamic Characteristics of Serum Hepatitis B Surface Antigen in Chinese Chronic Hepatitis B Patients Receiving 7 Years of Entecavir Therapy.
复制标题
中国慢性乙型肝炎患者恩替卡韦治疗7年血清乙型肝炎表面抗原动态特征
DOI：
10.4103/0366-6999.179802
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发表时间：
2016-04-20
影响因子：
6.1
通讯作者：
Xu XY
中科院分区：
文献类型：
--
作者：
Zhang XX;Li MR;Xi HL;Cao Y;Zhang RW;Zhang Y;Xu XY
背景：B型肝炎治疗的最终目标是清除B型肝炎表面抗原（HBsAg）。在抗病毒初治或拉米夫定治疗队列中，有几个因素与HBsAg降低率相关。然而，很少有研究评价长期恩替卡韦（ETV）治疗期间的因素。在本研究中，我们的目的是评估因素，预测结果的ETV治疗7年。方法：47例慢性B型肝炎（CH B）患者接受ETV单药治疗。在基线、3个月、6个月和每年1 - 7个月检测肝脏生化、B型肝炎病毒（HBV）血清学标志物、血清HBV DNA和HBsAg滴度。使用多变量检验和重复测量方差分析评估因素与HBsAg降低之间的关联。结果：基线时血清HBsAg水平与HBVDNA水平呈正相关（r = 0.625，P < 0.001）。ETV治疗后的平均HBsAg滴度显著低于基线滴度（P范围为0.025至0.000，000，6）。治疗1年内HBsAg转阴率高于治疗1年后（P < 0.05）。多因素分析显示，6个月时HBeAg血清学清除和/或HBsAg下降≥ 0.5log10IU/ml对HBsAg血清学清除有较高的阴性预测值（96.77%）（分别为P = 0.002，P = 0.012）。结论：治疗1年内HBsAg下降率大于治疗1年后。此外，HBeAg状态和HBsAg水平在6个月是最佳的因素，为早期预测HBsAg血清清除后，长期ETV治疗慢性乙型肝炎患者。
Background:The ultimate goal of hepatitis B treatment is hepatitis B surface antigen (HBsAg) seroclearance. Several factors have been suggested to be associated with the rate of HBsAg reduction in antiviral-naive or lamivudine therapy cohorts. However, there are few studies evaluating the factors during long-term entecavir (ETV) therapy. In the present study, we aimed to evaluate the factors to predict the outcome of ETV therapy for 7 years. Methods:A total of 47 chronic hepatitis B (CHB) patients treated with ETV monotherapy were included in this study. Liver biochemistry, hepatitis B virus (HBV) serological markers, serum HBV DNA, and HBsAg titers were tested at baseline, 3 months, 6 months, and yearly from 1 to 7. The associations between factors and HBsAg reduction were assessed using multivariate tests with repeated measure analysis of variance. Results:At baseline, serum HBsAg levels showed a positive correlation with baseline HBV DNA levels (r = 0.625, P < 0.001). The mean HBsAg titers after ETV treatment were significantly lower than the baseline titers (P ranges from 0.025 to 0.000,000,6). The HBsAg reduction rate during the 1st year was greater compared to after 1 year of treatment (P < 0.05). Multivariate test showed that hepatitis B e antigen (HBeAg) seroclearance and/or HBsAg reduction ≥0.5 log10 IU/ml at 6 months had a high negative predictive value (96.77%) for HBsAg seroclearance (P = 0.002, P = 0.012, respectively). Conclusions:The HBsAg reduction rate during the 1st year was greater than that after 1 year of treatment. Further, HBeAg status and HBsAg levels at month 6 are the optimal factors for the early prediction of HBsAg seroclearance after long-term ETV therapy in CHB patients.