Association of on-treatment serum hepatitis B surface antigen level with sustained virological response to nucleos(t)ide analog in patients with hepatitis B e-antigen positive chronic hepatitis B

作者：Kim Soon Sun; Lee Dami; Lee Myoung Hee; Cheong Jae Youn; Cho Sung Won^*

来源：Hepatology Research, 2013, 43(3): 219-227.

DOI：10.1111/j.1872-034X.2012.01065.x

• chronic hepatitis B
• hepatitis B e-antigen seroconversion
• hepatitis B surface antigen
• nucleos(t)ide analog
• virological response

Aim: This study evaluated the on-treatment serum hepatitis B surface antigen (HBsAg) level during nucleos(t)ide analog (NUC) therapy and the correlation with off-treatment sustained virological response (SVR). Methods: Fifty-one consecutive patients with hepatitis B e-antigen (HBeAg) positive chronic hepatitis B who achieved HBeAg loss/seroconversion after NUC therapy and completed 12months or more of additional therapy were included. Serum HBsAg and hepatitis B virus (HBV) DNA levels were determined at baseline, 3, 6, 9 and 12months, and at the end of treatment. SVR was defined as HBV DNA levels of less than 10000 copies/mL until 6 or 12months off-treatment without reappearance of HBeAg. Results: Twenty-two (43.1%) and 13 (25.5%) patients maintained SVR at 6 and 12months off-treatment, respectively. In univariate analyses, a decline of HBsAg of 0.5log10IU/mL or less at 6months (P=0.006) and 12months (P=0.013), the mean change in HBsAg level at 6months (P=0.024), and lamivudine or entecavir treatment (P=0.019) were significant predictive factors for SVR at 6months off-treatment. A decline of HBsAg of 0.5log10IU/mL or less at 6months and lamivudine or entecavir treatment were independent factors on multivariate analyses (odds ratio [OR], 16.67; 95% confidence interval [CI], 1.86142.86 [P=0.012]; and OR, 14.83; 95% CI, 1.18185.73 [P=0.036]; respectively). Conclusion: On-treatment serum HBsAg level predicted early off-treatment SVR to NUC therapy in patients infected with genotype C.

• 出版日期2013-3