乙型肝炎表面抗原
医学
恩替卡韦
内科学
胃肠病学
HBeAg
替诺福韦
乙型肝炎病毒
免疫学
病毒
拉米夫定
人类免疫缺陷病毒(HIV)
作者
Hsin-Wei Fang,Tsung–Hui Hu,Jing‐Houng Wang,Chao‐Hung Hung,Sheng‐Nan Lu,CH Chen
标识
DOI:10.1016/j.dld.2023.02.006
摘要
Little is known about the role of post-treatment HBsAg decline in HBsAg loss following nucleos(t)ide analogues cessation.HBeAg-negative patients without cirrhosis who previously received entecavir or tenofovir disoproxil fumarate (TDF) were enrolled (n=530). All patients were followed-up post-treatment for >24 months.Of the 530 patients, 126 achieved sustained response (Group I), 85 experienced virological relapse without clinical relapse and retreatment (Group II), 67 suffered clinical relapse without retreatment (Group III) and 252 received retreatment (Group IV). The cumulative incidence of HBsAg loss at 8 years was 57.3% in Group I, 24.1% in Group II, 35.9% in Group III and 7.3% in Group IV. Cox regression analysis showed that nucleos(t)ide analogue experience, lower HBsAg levels at end-of-treatment (EOT) and higher HBsAg decline at 6 months after EOT were independently associated with HBsAg loss in Group I and Groups II+III. The rates of HBsAg loss at 6 years in patients with HBsAg decline >0.2 log IU/mL in Group I and HBsAg decline >0.15 log IU/mL in Group II+III at 6 months after EOT were 87.7% and 47.1%, respectively.The HBsAg loss rate was high and post-treatment HBsAg decline could predict high HBsAg loss rate among HBeAg-negative patients who discontinued entecavir or TDF and did not need retreatment.
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