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核苷类似物治疗慢性乙型肝炎患者的 HBsAg 水平和临床过程:5 年随访数据。

HBsAg level and clinical course in patients with chronic hepatitis B treated with nucleoside analogue: five years of follow-up data.

机构信息

Digestive Disease Center, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.

Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea.

出版信息

Clin Mol Hepatol. 2013 Dec;19(4):409-16. doi: 10.3350/cmh.2013.19.4.409. Epub 2013 Dec 28.

Abstract

BACKGROUND/AIMS: Quantification of the hepatitis B surface antigen (HBsAg) is increasingly used to determine the treatment response in patients with chronic hepatitis B (CHB). However, there are limited data about the clinical implications of Quantification of HBsAg long-term nucleoside analogue treatment for CHB. We investigated the clinical correlation between HBsAg level and clinical course in patients with CHB who are treated long-term with nucleoside analogues.

METHODS

Patients with CHB who started lamivudine or entecavir monotherapy before June 2007 were enrolled. HBsAg was quantified at baseline, at 6 months, and at 1, 2, 3, 4, and 5 years of treatment. We compared data between the groups according to the presence or absence of a virological response (VR) and resistance.

RESULTS

Forty-eight patients were analyzed. There was no definite reduction in HBsAg level during the early period of treatment; differences in HBsAg levels between baseline and each time point were significant only at 5 years (P=0.028). In a subgroup analysis, this difference was significant only in non-resistant patients at 5 years (P=0.041).

CONCLUSIONS

There was no definite decrease in the HBsAg level during the early period of nucleoside analogue treatment, with long-term treatment being required to observe a significant reduction.

摘要

背景/目的:乙型肝炎表面抗原(HBsAg)的定量检测越来越多地用于评估慢性乙型肝炎(CHB)患者的治疗应答。然而,关于核苷(酸)类似物长期治疗 CHB 患者的 HBsAg 定量检测的临床意义的数据有限。我们研究了长期接受核苷类似物治疗的 CHB 患者的 HBsAg 水平与临床病程之间的临床相关性。

方法

本研究纳入了 2007 年 6 月之前开始使用拉米夫定或恩替卡韦单药治疗的 CHB 患者。在基线、治疗 6 个月以及治疗 1、2、3、4 和 5 年时对 HBsAg 进行定量检测。我们根据是否存在病毒学应答(VR)和耐药性来比较各组之间的数据。

结果

对 48 例患者进行了分析。在治疗早期 HBsAg 水平没有明确降低;仅在治疗 5 年时基线与各时间点之间的 HBsAg 水平差异有统计学意义(P=0.028)。在亚组分析中,仅在无耐药患者中,这一差异在治疗 5 年时具有统计学意义(P=0.041)。

结论

核苷(酸)类似物治疗早期 HBsAg 水平没有明确降低,需要长期治疗才能观察到明显降低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7191/3894441/785362b05948/cmh-19-409-g001.jpg

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