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在核苷(酸)类似物诱导 HBeAg 血清学转换后,白人种族,而非停药,与 HBsAg 丢失相关。

Caucasian Ethnicity, but Not Treatment Cessation is Associated with HBsAg Loss Following Nucleos(t)ide Analogue-Induced HBeAg Seroconversion.

机构信息

Department of Gastroenterology and Hepatology, Antwerp University Hospital, 2650 Antwerp, Belgium.

Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, 2650 Antwerp, Belgium.

出版信息

Viruses. 2019 Jul 26;11(8):687. doi: 10.3390/v11080687.

Abstract

It is well appreciated that ethnicity influences the natural history and immune responses during a chronic hepatitis B infection. In this study, we explore the effect of ethnicity and treatment cessation on Hepatitis B surface Antigen (HBsAg) seroclearance in patients with Nucleos(t)ide Analogue (NA)-induced Hepatitis B e Antigen (HBeAg) seroconversion. We performed a multi-ethnic, multicentric observational cohort study. The analyzed cohort consisted of 178 mono-infected, predominantly male (75.3%) chronic hepatitis B patients of mixed ethnicity (44.4% Asians, 48.9% Caucasians) with nucleos(t)ide analogue-induced HBeAg seroconversion. Treatment was withdrawn in 105 patients and continued in 73, leading to HBsAg loss in 14 patients off- and 16 patients on-treatment, respectively. Overall, HBsAg loss rates were not affected by treatment cessation (hazard ratio 1.45, = 0.372), regardless of consolidation treatment duration. Caucasian ethnicity was associated with an increased chance of HBsAg loss (hazard ratio 6.70, = 0.001), but hepatitis B virus genotype was not ( = 0.812). In conclusion, ethnicity is the most important determinant for HBsAg loss after NA-induced HBeAg seroconversion, with up to six-fold higher HBsAg loss rates in Caucasians compared to Asians, irrespective of treatment cessation and consolidation treatment duration.

摘要

众所周知,种族会影响慢性乙型肝炎感染期间的自然史和免疫反应。在这项研究中,我们探讨了种族和停药对核苷(酸)类似物诱导乙型肝炎 e 抗原(HBeAg)血清学转换患者乙型肝炎表面抗原(HBsAg)血清学清除的影响。我们进行了一项多民族、多中心观察性队列研究。分析队列包括 178 名混合种族(44.4%亚洲人,48.9%高加索人)的单感染、以男性为主(75.3%)的慢性乙型肝炎患者,他们均接受核苷(酸)类似物诱导的 HBeAg 血清学转换。105 名患者停用治疗,73 名患者继续治疗,分别导致 14 名停药和 16 名治疗患者的 HBsAg 丢失。总的来说,停药与否并不影响 HBsAg 丢失率(危险比 1.45, = 0.372),无论巩固治疗持续时间如何。白种人种族与 HBsAg 丢失的几率增加相关(危险比 6.70, = 0.001),但乙型肝炎病毒基因型则不然( = 0.812)。总之,种族是核苷(酸)类似物诱导 HBeAg 血清学转换后 HBsAg 丢失的最重要决定因素,与亚洲人相比,高加索人 HBsAg 丢失率高达 6 倍,无论停药和巩固治疗持续时间如何。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec80/6723144/27ed3dcaf417/viruses-11-00687-g001.jpg

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