慢性乙型肝炎患者停用核苷（酸）类似物后的结局：复发率及相关因素
Outcome after discontinuation of nucleot(s)ide analogues in chronic hepatitis B: relapse rate and associated factors.
作者信息
Kranidioti Hariklia, Manolakopoulos Spilios, Khakoo Salim I
机构信息
Department of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, United Kingdom (Hariklia Kranidioti, Salim I. Khakoo).
2 Academic Department of Internal Medicine, Hippokration General Hospital, University of Athens, Greece (Spilios Manolakopoulos).
出版信息
Ann Gastroenterol. 2015 Apr-Jun;28(2):173-181.
Abstract
The introduction of nucleot(s)ide analogues (NAs) for oral antiviral therapy has dramatically improved the clinical outcome of patients with chronic hepatitis B. NAs appear to be safe and induce potent suppression of viral replication. However, they are associated with a low rate of HBsAg seroclearance, the gold standard of successful treatment, and also with a relatively high rate of virological relapse after discontinuation. As a result, long-term treatment is needed. The optimal duration of NA treatment currently remains unclear, nevertheless in some patients NA treatment can be stopped with a relatively low probability of relapse. Whether NAs are able to induce a sustained off-treatment response is an important area for research. This article reviews the relapse rate after cessation of treatment with NAs in chronic hepatitis B patients with the goal of identifying possible predictive factors of relapse.
摘要
核苷酸类似物（NAs）用于口服抗病毒治疗显著改善了慢性乙型肝炎患者的临床结局。NAs似乎安全且能有效抑制病毒复制。然而，它们与成功治疗的金标准——HBsAg血清学清除率较低相关，且停药后病毒学复发率相对较高。因此，需要进行长期治疗。目前NA治疗的最佳疗程仍不清楚，不过在一些患者中，NA治疗停药后复发概率相对较低。NAs是否能够诱导持续的停药后反应是一个重要的研究领域。本文回顾了慢性乙型肝炎患者停用NA治疗后的复发率，目的是确定可能的复发预测因素。
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本文引用的文献
1
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BMC Infect Dis. 2014 Aug 13;14:439. doi: 10.1186/1471-2334-14-439.
2
Treatment cessation of entecavir in Asian patients with hepatitis B e antigen negative chronic hepatitis B: a multicentre prospective study.恩替卡韦治疗乙型肝炎 e 抗原阴性慢性乙型肝炎亚洲患者停药：一项多中心前瞻性研究。
Gut. 2015 Apr;64(4):667-72. doi: 10.1136/gutjnl-2014-307237. Epub 2014 May 15.
3
The role of hepatitis B surface antigen quantification in predicting HBsAg loss and HBV relapse after discontinuation of lamivudine treatment.乙型肝炎表面抗原定量在预测拉米夫定停药后 HBsAg 丢失和 HBV 复发中的作用。
J Hepatol. 2014 Sep;61(3):515-22. doi: 10.1016/j.jhep.2014.04.029. Epub 2014 May 2.
4
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Gut. 2015 Jan;64(1):139-47. doi: 10.1136/gutjnl-2013-305707. Epub 2014 Feb 20.
5
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Gut. 2014 Aug;63(8):1325-32. doi: 10.1136/gutjnl-2013-305517. Epub 2013 Oct 25.
6
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7
Long-term outcomes after nucleos(t)ide analogues discontinuation in chronic hepatitis B patients with HBeAg-negative.HBeAg阴性慢性乙型肝炎患者停用核苷（酸）类似物后的长期结局
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8
Relapse of chronic hepatitis B after discontinuation of nucleos(t)ide analogs: is the glass half full or half empty?核苷（酸）类似物停药后慢性乙型肝炎复发：情况是喜还是忧？
Hepatology. 2013 Dec;58(6):1885-7. doi: 10.1002/hep.26708. Epub 2013 Oct 23.
9
Hepatitis B surface antigen seroclearance in patients with chronic hepatitis B infection: a clinical study.慢性乙型肝炎感染患者的乙肝表面抗原血清学清除：一项临床研究。
J Int Med Res. 2013 Oct;41(5):1732-9. doi: 10.1177/0300060513487643. Epub 2013 Aug 1.
10
Relapse rate and associated-factor of recurrence after stopping NUCs therapy with different prolonged consolidation therapy in HBeAg positive CHB patients.HBeAg 阳性 CHB 患者停止 NUCs 治疗后不同延长巩固治疗的复发率及相关因素。
PLoS One. 2013 Jul 3;8(7):e68568. doi: 10.1371/journal.pone.0068568. Print 2013.
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