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