HBeAg-positive patients with HBsAg < 100 IU/mL and negative HBV RNA have lower risk of virological relapse after nucleos(t)ide analogues cessation.
HBeAg-positive patients with HBsAg < 100 IU/mL and negative HBV RNA have lower risk of virological relapse after nucleos(t)ide analogues cessation.
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HBsAg < 100 IU/mL的HBeAg阳性患者和HBV RNA阴性患者在核苷（酸）类似物停药后病毒学复发的风险较低。
DOI：
10.1007/s00535-021-01812-0
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发表时间：
2021-09
影响因子：
6.3
通讯作者：
Feng B
中科院分区：
文献类型：
--
作者：
Xie Y;Li M;Ou X;Zheng S;Gao Y;Xu X;Yang Y;Ma A;Li J;Huang Y;Nan Y;Zheng H;Feng B
核苷（酸）类似物（NAs）停药尚未得到广泛应用，仍是一个有争议的问题，但与感染B病毒（HBV）的患者高度相关。我们的目的是探讨安全的NAs戒烟的相关因素。 这是一项多中心前瞻性队列研究。总体而言，在中国的12家医院纳入了139例符合停止标准的初始HBV e抗原（HBeAg）阳性患者。入组患者停止NA，每3个月随访一次，持续24个月或直至临床复发（CR）。24个月累计病毒学复发率（VR）为50.4%，完全缓解率（CR）为24.5%，HBeAg转阴率为11.5%，HBsAg转阴率为9.4%。治疗结束（EOT）HBsAg < 100 IU/mL且HBV RNA阴性的患者24个月累积VR率最低（5 vs 58%，p < 0.001）。EOT HBsAg ≥ 2 log 10 IU/mL [比值比（OR）= 6.686，p = 0.006]、EOT HBV RNA阳性（OR = 3.453，p = 0.008）和EOT B核心相关抗原（HBcrAg）≥ 4 log U/mL（OR = 3.702，p = 0.002）可独立预测VR风险。为了预测VR，EOT HBsAg < 100 IU/mL加EOT HBV RNA阴性的受试者工作特征（AUROC）值下的面积为0.698（p < 0.001），高于其他参数单独或组合。NAs的停止仅适用于少数和选定的患者。EOT HBsAg < 100 IU/mL和EOT阴性HBV RNA确定了1例停止治疗VR风险较低的患者。
Nucleos(t)ide analogues (NAs) cessation is not widely practiced and remains a controversial, but highly relevant subject in patients infected with hepatitis B virus (HBV). We aimed to explore the related factors for safe NAs cessation. This is a multicenter prospective cohort study. Overall, 139 initially HBV e antigen (HBeAg)-positive patients meeting the stopping criteria were included in 12 hospitals in China. Enrolled patients ceased NAs and were followed up every 3 months for 24 months or until clinical relapse (CR). The 24 month cumulative rates of virological relapse (VR), CR, HBeAg reversion and HBV surface antigen (HBsAg) loss were 50.4, 24.5, 11.5 and 9.4%, respectively. Patients with end of treatment (EOT) HBsAg < 100 IU/mL plus negative HBV RNA had the lowest 24 month cumulative VR rate (5 vs 58%, p < 0.001). EOT HBsAg ≥ 2 log10 IU/mL [odds ratio (OR) = 6.686, p = 0.006], EOT positive HBV RNA (OR = 3.453, p = 0.008) and EOT hepatitis B core-related antigen (HBcrAg) ≥ 4log U/mL (OR = 3.702, p = 0.002) were found to independently predict the risk of VR. To predict VR, the area under the receiver-operating characteristic (AUROC) value of the EOT HBsAg < 100 IU/mL plus EOT HBV RNA negative was 0.698 (p < 0.001), which was higher than other parameters alone or combinations. NAs cessation is suitable only for a small and selected patients. An EOT HBsAg < 100 IU/mL and EOT negative HBV RNA identified a patient with low risk of off-treatment VR.
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影响因子：
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作者：
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