Wang Chia-Chi, Tseng Tai-Chung, Wang Pin-Chao, Lin Hans Hsienhong, Kao Jia-Horng
Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and School of Medicine, Tzu Chi University, Hualien, Taiwan.
Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and School of Medicine, Tzu Chi University, Hualien, Taiwan.
J Formos Med Assoc. 2014 Nov;113(11):786-93. doi: 10.1016/j.jfma.2013.06.003. Epub 2013 Aug 1.
BACKGROUND/PURPOSE: Several anti-viral drugs are approved for the treatment of hepatitis B virus (HBV) infection. However, whether quantitative hepatitis B surface antigen (qHBsAg) can predict the therapeutic response during long-term entecavir treatment remains unclear.
Fifty-five chronic hepatitis B (CHB) patients who received entecavir for more than 2 years were enrolled. The serum qHBsAg level was measured by HBsAg II quant immunoassay. A significant decline in the qHBsAg level was defined as > 1 log reduction from baseline to 6 months of entecavir treatment.
Of the 55 patients (41 males and 14 females with a mean age of 48.3 ± 11.4 years), 23 patients were positive for hepatitis B e antigen (HBeAg). The median treatment period was 34 months, and ranged from 26 months to 43 months. A total of 288 serum samples were used to determine the qHBsAg levels. At year 3 of entecavir therapy, one (1.8%) patient had HBsAg seroclearance. A high qHBsAg level was defined as greater than 10,000 IU/mL. Patients with a high baseline qHBsAg level had a lower rate of virologic response at year 1 (37.5% vs. 89.7%, p < 0.001) and year 2 (56.2% vs. 94.9%, p = 0.001). In this study population, 14.5% had a significant decline of the qHBsAg level. A significant decline could not predict HBeAg loss in HBeAg-positive or virologic response in all patients.
The baseline serum qHBsAg level can predict virologic response in entecavir-treated CHB patients. However, a significant decline in the qHBsAg level cannot predict serologic or virologic response of entecavir treatment.
背景/目的：几种抗病毒药物已被批准用于治疗乙型肝炎病毒（HBV）感染。然而，定量乙肝表面抗原（qHBsAg）能否预测恩替卡韦长期治疗期间的治疗反应仍不清楚。
纳入55例接受恩替卡韦治疗超过2年的慢性乙型肝炎（CHB）患者。采用HBsAg II定量免疫测定法检测血清qHBsAg水平。qHBsAg水平显著下降定义为从基线到恩替卡韦治疗6个月下降>1 log。
55例患者（41例男性和14例女性，平均年龄48.3±11.4岁）中，23例乙肝e抗原（HBeAg）阳性。中位治疗期为34个月，范围为26个月至43个月。共采集288份血清样本用于测定qHBsAg水平。在恩替卡韦治疗第3年，1例（1.8%）患者实现HBsAg血清学清除。高qHBsAg水平定义为大于10,000 IU/mL。基线qHBsAg水平高的患者在第1年（37.5%对89.7%，p<0.001）和第2年（56.2%对94.9%，p = 0.001）的病毒学应答率较低。在本研究人群中，14.5%的患者qHBsAg水平有显著下降。显著下降不能预测HBeAg阳性患者的HBeAg消失或所有患者的病毒学应答。
基线血清qHBsAg水平可预测恩替卡韦治疗的CHB患者的病毒学应答。然而，qHBsAg水平的显著下降不能预测恩替卡韦治疗的血清学或病毒学应答。
