Long-term incidence and predictors of hepatitis B surface antigen loss after discontinuing nucleoside analogues in noncirrhotic chronic hepatitis B patients
Long-term incidence and predictors of hepatitis B surface antigen loss after discontinuing nucleoside analogues in noncirrhotic chronic hepatitis B patients
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DOI：
10.1016/j.cmi.2017.12.013
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发表时间：
2018-09-01
影响因子：
14.2
通讯作者：
Lee, C. -M.
中科院分区：
文献类型：
--
作者：
Chen, C. -H.;Hung, C. -H.;Lee, C. -M.
目的：探讨核苷类似物治疗后乙型肝炎表面抗原（HBsAg）丧失的长期发生率和预测因素。方法：该研究纳入了 411 名非肝硬化慢性乙型肝炎患者（148 名乙型肝炎 e 抗原（HBeAg）阳性患者和 263 名 HBeAg 阴性患者），他们接受拉米夫定（n = 110）或恩替卡韦（n = 301）治疗，治疗后随访至少12个月。结果：在HBeAg阳性患者中，8年累积病毒学复发率、临床复发率和HBsAg消失率分别为55.6%、47.7%和19.6%。在 HBeAg 阴性患者中，这一比例分别为 69.3%、58.9% 和 33.1%。 Cox回归分析显示，乙型肝炎病毒C基因型和治疗结束时较低的HBsAg水平是HBeAg阳性和阴性患者HBsAg消失的独立预测因素。治疗结束时 HBsAg 水平的 HBeAg 阳性患者的 5 年 HBsAg 消失率为 47.3%
Objective: To investigate the long-term incidence and predictors for hepatitis B surface antigen (HBsAg) loss after nucleoside analogue therapy.Methods: The study included 411 noncirrhotic chronic hepatitis B patients (148 hepatitis B e antigen (HBeAg)-positive and 263 HBeAg-negative patients) who were treated with lamivudine (n = 110) or entecavir (n = 301) with posttreatment follow-up of at least 12 months.Results: In HBeAg-positive patients, the 8-year cumulative rates of virologic relapse, clinical relapse and HBsAg loss were 55.6%, 47.7% and 19.6%, respectively. In HBeAg-negative patients, the rates were 69.3%, 58.9% and 33.1%, respectively. Cox regression analysis showed that hepatitis B virus genotype C and lower end-of-treatment HBsAg levels were independent predictors of HBsAg loss in HBeAg-positive and -negative patients. The 5-year HBsAg loss rate was 47.3% in HBeAg-positive patients with end-of-treatment HBsAg levels