Department of Gastroenterology, Hepatology, and Endocrinology, Hannover Medical School, Hannover.
Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China.
J Infect Dis. 2018 Sep 22;218(9):1480-1484. doi: 10.1093/infdis/jiy350.
Stopping long-term nucleos(t)ide analogue therapy increases hepatitis B virus (HBV) surface antigen (HBsAg) loss rates in HBV e antigen (HBeAg)-negative patients. Viral rebound may induce immune responses facilitating functional cure. We analyzed which factors are associated with timing of virological relapse in 220 Asian HBeAg-negative patients from the prospective ABX203 vaccine study. Unexpectedly, only the type of antiviral therapy was significantly associated with early virological relapse, defined as an HBV DNA load of >2000 IU/mL until week 12, and relapse occurred earlier in patients treated with tenofovir versus those treated with entecavir (median time, 6 vs 24 weeks; P < .0001). This should be considered for future trials and monitoring of patients after treatment discontinuation.
停止长期核苷（酸）类似物治疗可提高 HBeAg 阴性患者乙型肝炎病毒表面抗原（HBsAg）的丢失率。病毒反弹可能会诱导免疫反应，从而促进功能性治愈。我们分析了哪些因素与 220 例来自前瞻性 ABX203 疫苗研究的亚洲 HBeAg 阴性患者的病毒学复发时间有关。出乎意料的是，只有抗病毒治疗的类型与早期病毒学复发显著相关，定义为 HBV DNA 载量>2000 IU/mL 直至第 12 周，且与恩替卡韦相比，替诺福韦治疗的患者更早出现复发（中位时间，6 周比 24 周；P<0.0001）。这在未来的试验和治疗停药后患者的监测中应予以考虑。
