Department of Gastroenterology and Hepatology, Antwerp University Hospital, 2650 Antwerp, Belgium.
Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, 2650 Antwerp, Belgium.
Viruses. 2019 Jul 26;11(8):687. doi: 10.3390/v11080687.
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 Treatment was withdrawn in 105 patients and continued in 73, leading to HBsAg loss in 14 patients off- and 16 patients on-treatment, respectively.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.
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。