Durability of viral response after off-treatment in HBeAg positive chronic hepatitis B  

作　　者：Myeong Jun Song Do Seon Song Hee Yeon Kim Sun Hong Yoo Si Hyun Bae Jong Young Choi Seung Kew Yoon Yong-Han Paik June Sung Lee Hyun Woong Lee Hyung Joon Kim 

机构地区：[1]Departments of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 137-040, South Korea [2]Departments of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea [3]Departments of Internal Medicine, College of Medicine, Inje University Ilsan Paik Hospital of The Korea, Goyang-si 411-706, South Korea [4]Departments of Internal Medicine, College of Medicine, The Chung-Ang University of Korea, Seoul 156-755, South Korea

出　　处：《World Journal of Gastroenterology》2012年第43期6277-6283,共7页世界胃肠病学杂志（英文版）

摘　　要：AIM:To evaluate the durability in hepatitis B e antigen (HBeAg) positive chronic hepatitis B patients who discontinued antiviral treatment. METHODS:A total of 48 HBeAg positive chronic hepatitis B patients who were administered nucleoside analogues and maintained virological response for ≥ 6 mo [hepatitis B virus (HBV) DNA < 300 copies/mL and HBeAg seroconversion] before cessation of treatment were enrolled between February 2007 and January 2010. The criteria for the cessation of the antiviral treatment were defined as follows:(1) achievement of virological response; and (2) duration of consolidation therapy (≥ 6 mo). After treatment cessation, the patients were followed up at 3-6 mo intervals. The primary endpoint was serologic and virologic recurrence rates after withdrawal of antiviral treatment. Serologic recurrence was defined as reappearance of HBeAg positivity after HBeAg seroconversion. Virologic recurrence was defined as an increase in HBV-DNA level > 104 copies/mL after HBeAg seroconversion with previously undetectable HBV-DNA level. RESULTS:During the median follow-up period of 18.2 mo (range:5.1-47.5 mo) after cessation of antiviral treatment, the cumulative serological recurrence rate was 15 % at 12 mo. The median duration between the cessation of antiviral treatment and serologic recurrence was 7.2 mo (range:1.2-10.9 mo). Of the 48 patients with HBeAg positive chronic hepatitis, 20 (41.6%) showed virological recurrence. The cumulative virologic recurrence rates at 12 mo after discontinuing the antiviral agent were 41%. The median duration between off-treatment and virologic recurrence was 7.6 mo (range:4.3-27.1 mo). The mean age of the virological recurrence group was older than that of the non-recurrence group (46.7 ± 12.1 years vs 38.8 ± 12.7 years, respectively; P = 0.022). Age (> 40 years) and the duration of consolidation treatment (≥ 15 mo) were significant predictive factors for offtreatment durability in the multivariate analysis [P = 0.049, relative risk (RR) 0.31, 95% CI (0.096-0.9AIM：To evaluate the durability in hepatitis B e antigen （HBeAg） positive chronic hepatitis B patients who discontinued antiviral treatment. METHODS：A total of 48 HBeAg positive chronic hepatitis B patients who were administered nucleoside analogues and maintained virological response for ≥ 6 mo [hepatitis B virus （HBV） DNA 300 copies/mL and HBeAg seroconversion] before cessation of treatment were enrolled between February 2007 and January 2010. The criteria for the cessation of the antiviral treatment were defined as follows：（1） achievement of virological response; and （2） duration of consolidation therapy （≥ 6 mo）. After treatment cessation, the patients were followed up at 3-6 mo intervals. The primary endpoint was serologic and virologic recurrence rates after withdrawal of antiviral treatment. Serologic recurrence was defined as reappearance of HBeAg positivity after HBeAg seroconversion. Virologic recurrence was defined as an increase in HBV-DNA level 104 copies/mL after HBeAg seroconversion with previously undetectable HBV-DNA level. RESULTS：During the median follow-up period of 18.2 mo （range：5.1-47.5 mo） after cessation of antiviral treatment, the cumulative serological recurrence rate was 15 % at 12 mo. The median duration between the cessation of antiviral treatment and serologic recurrence was 7.2 mo （range：1.2-10.9 mo）. Of the 48 patients with HBeAg positive chronic hepatitis, 20 （41.6%） showed virological recurrence. The cumulative virologic recurrence rates at 12 mo after discontinuing the antiviral agent were 41%. The median duration between off-treatment and virologic recurrence was 7.6 mo （range：4.3-27.1 mo）. The mean age of the virological recurrence group was older than that of the non-recurrence group （46.7 ± 12.1 years vs 38.8 ± 12.7 years, respectively; P = 0.022）. Age （ 40 years） and the duration of consolidation treatment （≥ 15 mo） were significant predictive factors for offtreatment durability in the multivariate analys

关 键 词：DURABILITY SEROCONVERSION Chronic hepatitis B Hepatitis B e antigen positive RECURRENCE CONSOLIDATION 

分 类 号：R512.62[医药卫生—内科学]