ALT to qHBsAg ratio predicts long-term HBsAg seroclearance after entecavir cessation in Chinese patients with chronic hepatitis B

恩替卡韦 医学 乙型肝炎表面抗原 胃肠病学 内科学 慢性肝炎 HBeAg 接收机工作特性 乙型肝炎病毒 免疫学 病毒 拉米夫定
作者
Ryan Hin-Man Leung,Rex Wan‐Hin Hui,Lung‐Yi Mak,Xianhua Mao,Kevin Sze-Hang Liu,Danny Ka‐Ho Wong,James Fung,Wai‐Kay Seto,Man‐Fung Yuen
出处
期刊:Journal of Hepatology [Elsevier BV]
卷期号:81 (2): 218-226 被引量:12
标识
DOI:10.1016/j.jhep.2024.03.022
摘要

Background Factors predicting HBsAg seroclearance after treatment cessation, irrespective of nucleos(t)ide analogue (NA) resumption, have important clinical implications. We evaluated predictors of long-term HBsAg seroclearance after entecavir cessation. Methods This study followed up Chinese chronic hepatitis B patients from two previous studies of entecavir cessation. All patients were non-cirrhotic, HBeAg-negative, with undetectable HBV DNA (<20 IU/ml) at end-of-treatment (EOT). They had close monitoring for 48 weeks with regular HBV DNA, qHBsAg and ALT measurements. Entecavir was resumed at HBV DNA >2000 IU/ml, irrespective of ALT levels. After the initial 48 weeks, patients were assessed every six months, regardless of entecavir resumption, to monitor for HBsAg seroclearance. Results 194 patients (63.4% male, mean age 49.9 years, on entecavir for a median of 47.2 months) were recruited. 94 (48.5%) and 158 (81.4%) patients had EOT qHBsAg <100 IU/ml and <1000 IU/ml respectively. 151 (77.8%) patients were eventually resumed on entecavir. After follow-up for a median of 70.7 (51.0-118.2) months, 28 (14.4%) patients had HBsAg seroclearance. qHBsAg levels at weeks 36 and 48 after EOT independently predicted HBsAg seroclearance (both p<0.01), whereas qHBsAg from EOT to week 24 only trended towards statistical significance. The ratio of ALT/qHBsAg at all time points from EOT to week 48 independently predicted HBsAg seroclearance (HR ranging from 1.003-1.028, all p<0.01) with excellent diagnostic performance (Area-under-receiver-operating-characteristics 0.799-0.933, negative-predictive-value >90% at different time points), regardless of whether entecavir was resumed. Conclusions The ALT/qHBsAg ratio after entecavir cessation predicts HBsAg seroclearance, even in patients who were resumed on treatment. Its use may mitigate the risk of severe hepatitis flares in patients managed by observation without treatment resumption.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
1秒前
1秒前
1秒前
3秒前
dudu发布了新的文献求助10
3秒前
3秒前
nanlinhua发布了新的文献求助10
3秒前
MrCoolWu完成签到,获得积分10
4秒前
斯文败类应助科研通管家采纳,获得10
5秒前
今后应助科研通管家采纳,获得10
5秒前
彭于晏应助科研通管家采纳,获得10
5秒前
汉堡包应助科研通管家采纳,获得10
5秒前
斯文败类应助科研通管家采纳,获得10
5秒前
5秒前
充电宝应助李某采纳,获得10
5秒前
烟花应助科研通管家采纳,获得10
5秒前
深情安青应助科研通管家采纳,获得10
5秒前
赘婿应助科研通管家采纳,获得10
5秒前
5秒前
5秒前
胡广发布了新的文献求助10
6秒前
golf发布了新的文献求助10
6秒前
甜蜜屁池发布了新的文献求助10
7秒前
snsut完成签到,获得积分10
7秒前
7秒前
7秒前
李爱国应助carrier_hc采纳,获得50
8秒前
Lsy完成签到,获得积分10
8秒前
8秒前
9秒前
任性的香烟完成签到,获得积分10
9秒前
刘梦婷发布了新的文献求助10
10秒前
洺全发布了新的文献求助10
12秒前
sheep完成签到 ,获得积分10
12秒前
深情安青应助BICEIT采纳,获得10
12秒前
zhuhaot发布了新的文献求助50
12秒前
Yiwuer完成签到,获得积分10
12秒前
大模型应助寒冷的咖啡采纳,获得10
13秒前
13秒前
golf完成签到,获得积分10
14秒前
高分求助中
The Mother of All Tableaux Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 2400
Ophthalmic Equipment Market by Devices(surgical: vitreorentinal,IOLs,OVDs,contact lens,RGP lens,backflush,diagnostic&monitoring:OCT,actorefractor,keratometer,tonometer,ophthalmoscpe,OVD), End User,Buying Criteria-Global Forecast to2029 2000
Cognitive Neuroscience: The Biology of the Mind (Sixth Edition) 1000
Optimal Transport: A Comprehensive Introduction to Modeling, Analysis, Simulation, Applications 800
Official Methods of Analysis of AOAC INTERNATIONAL 600
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 588
A Preliminary Study on Correlation Between Independent Components of Facial Thermal Images and Subjective Assessment of Chronic Stress 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3958130
求助须知:如何正确求助?哪些是违规求助? 3504312
关于积分的说明 11117892
捐赠科研通 3235623
什么是DOI,文献DOI怎么找? 1788403
邀请新用户注册赠送积分活动 871211
科研通“疑难数据库(出版商)”最低求助积分说明 802547