Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
J Infect Dis. 2011 Aug 1;204(3):415-8. doi: 10.1093/infdis/jir282.
Nucleos(t)ide analogues strongly inhibit viral replication in chronic hepatitis B (CHB) infection, but knowledge of their long-term effect on serum hepatitis B surface antigen (HBsAg) levels and HBsAg loss is lacking. Seventy-five CHB patients with virological response (VR) to ETV or TDF were included. HBsAg decline 2 years after VR was most pronounced in HBeAg-positive patients. Age, alanine aminotransferase, and HBeAg loss were associated with HBsAg decline in HBeAg-positive patients. Predicted median time to HBsAg loss was 36 years for HBeAg-positive and 39 years for HBeAg-negative patients. Thus, most patients treated with ETV and TDF will probably need decades of therapy to achieve HBsAg loss.
核苷（酸）类似物在慢性乙型肝炎（CHB）感染中强烈抑制病毒复制，但缺乏对其长期血清乙型肝炎表面抗原（HBsAg）水平和 HBsAg 丢失影响的了解。本研究纳入了 75 例对 ETV 或 TDF 有病毒学应答（VR）的 CHB 患者。VR 后 2 年 HBsAg 下降最明显的是 HBeAg 阳性患者。年龄、丙氨酸氨基转移酶和 HBeAg 丢失与 HBeAg 阳性患者的 HBsAg 下降相关。预测 HBeAg 阳性和 HBeAg 阴性患者发生 HBsAg 丢失的中位时间分别为 36 年和 39 年。因此，大多数接受 ETV 和 TDF 治疗的患者可能需要数十年的治疗才能实现 HBsAg 丢失。
