Περίληψη:
Background/Aims: Serum hepatitis B s antigen (HBsAg) levels might be used as a predictor of virological breakthrough or of sustained off-treatment virological response in hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB) patients. We evaluated the changes of HBsAg in those patients under nucleos(t)ide analogue(s) [NA(s)] therapy for ≥12 months. Methods: We included 99 HBeAg-negative CHB patients treated with low-genetic barrier NA(s) for a mean of 66 months (lamivudine: 66, adefovir: 6, lamivudine plus adefovir: 11 and telbivudine: 16) and 86 HBeAg-negative CHB patients treated under entecavir or tenofovir for a mean of 30 months as the comparison group. Results: Compared to baseline, HBsAg levels decreased by a median of 162, 1525, 943, 1545, 2163 and 3859 IU/mL at 6, 12, 24, 36, 48 and 60 months of therapy with low-genetic barrier NA(s) respectively. The 6-, 12-, 24-, 36-, 48- and 60-month cumulative rates of HBsAg<100 IU/mL were 2%, 3%, 3%, 5%, 5% and 5%, and <1000 IU/mL 6%, 9%, 15%, 19%, 24% and 61% respectively. Baseline HBsAg levels were the only significant variable associated with the time to HBsAg drop <1000 IU/mL. HBsAg loss occurred in 3.0% of patients. The high-genetic barrier NAs were not found to offer a greater or faster HBsAg decline. Conclusions: In HBeAg-negative CHB patients, long-term therapy with low-genetic barrier NA(s) decreases serum HBsAg levels, but the rate of decline is slow. Lower baseline HBsAg levels are significantly associated with on-therapy HBsAg drop <1000 IU/mL. Serum HBsAg decline is similar during therapy with low- or high-genetic barrier NAs. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Συγγραφείς:
Striki, A.
Manolakopoulos, S.
Deutsch, M.
Kourikou, A.
Kontos, G.
Kranidioti, H.
Hadziyannis, E.
Papatheodoridis, G.
Λέξεις-κλειδιά:
adefovir; alanine aminotransferase; entecavir; hepatitis B surface antigen; hepatitis B(e) antigen; lamivudine; nucleoside analog; telbivudine; tenofovir; tenofovir disoproxil; virus DNA; antivirus agent; hepatitis B surface antigen; hepatitis B(e) antigen; virus DNA, adult; Article; chronic hepatitis B; cohort analysis; comparative study; controlled study; female; follow up; human; liver cirrhosis; long term care; major clinical study; male; middle aged; remission; treatment duration; aged; blood; chronic hepatitis B; Hepatitis B virus; kinetics; proportional hazards model, Adult; Aged; Antiviral Agents; DNA, Viral; Female; Hepatitis B e Antigens; Hepatitis B Surface Antigens; Hepatitis B virus; Hepatitis B, Chronic; Humans; Kinetics; Male; Middle Aged; Proportional Hazards Models
