Yu Weiyan, Wang Yadong, Shen Chuan, Ji Ru, Zhang Li, Zhao Xin, Su Miao, Zhang Ying, He Wenyan, Cao Jianguo, Hao Yanshuang, Chen Shengpeng, Zhao Caiyan
Department of Infectious Diseases, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang, China.
Cangzhou Contagious Hospital of Hebei Province, Cangzhou, China.
Braz J Infect Dis. 2017 May-Jun;21(3):213-218. doi: 10.1016/j.bjid.2017.03.001. Epub 2017 Mar 27.
To evaluate the HBeAg seroconversion rate in real clinical setting and explore its predictors in long-term nucleos(t)ide analogues (NAs) treatment for chronic hepatitis B (CHB).
251 patients were recruited from January 2001 to September 2009 in four hospitals in Hebei province, China, for this retrospective study. Clinical and laboratory data before and after treatment with lamivudine (LAM, 100mg daily), adefovir (ADV, 10mg daily), telbivudine (LDT, 600mg daily), entecavir (ETV, 0.5mg daily), and LAM/ADV combination were compared among three groups according to treatment outcomes: synchronous HBeAg loss and HBeAg seroconversion, anti-HBe development after treatment, and no anti-HBe. Adherence was also evaluated.
In real clinical setting, cumulative HBeAg seroconversion rates were 14.3%, 32.7%, 43.0%, 46.9%, and 50.5% after 1, 2, 3, 5, and 8 years, respectively. 45 patients (17.9%) were non-adherent. Adherence (p<0.001, Hazard Ratio (HR)=2.203), elevated alanine aminotransferase (ALT) levels (p<0.001, HR=2.049), and non-vertical transmission (p=0.006, HR=1.656) were predictors of HBeAg seroconversion.
Adherence, elevated ALT, and non-vertical transmission are predictors of HBeAg seroconversion in CHB patients treated with NAs.
评估在实际临床环境中HBeAg血清学转换率，并探讨其在慢性乙型肝炎（CHB）长期核苷（酸）类似物（NA）治疗中的预测因素。
2001年1月至2009年9月在中国河北省的四家医院招募了251例患者进行这项回顾性研究。根据治疗结果将三组患者使用拉米夫定（LAM，每日100mg）、阿德福韦（ADV，每日10mg）、替比夫定（LDT，每日600mg）、恩替卡韦（ETV，每日0.5mg）以及LAM/ADV联合治疗前后的临床和实验室数据进行比较：HBeAg同步消失和血清学转换、治疗后抗-HBe出现以及无抗-HBe。同时评估依从性。
在实际临床环境中，1、2、3、5和8年后累积HBeAg血清学转换率分别为14.3%、32.7%、43.0%、46.9%和50.5%。45例患者（17.9%）不依从。依从性（p<0.001，风险比（HR）=2.203）、丙氨酸氨基转移酶（ALT）水平升高（p<0.001，HR=2.049）和非垂直传播（p=0.006，HR=1.656）是HBeAg血清学转换的预测因素。
依从性、ALT升高和非垂直传播是接受NA治疗的CHB患者HBeAg血清学转换的预测因素。
