Discontinuation of oral antivirals in chronic hepatitis B: A systematic review

中止 医学 HBeAg 内科学 慢性肝炎 胃肠病学 乙型肝炎 抗病毒治疗 肝炎 乙型肝炎病毒 免疫学 病毒 乙型肝炎表面抗原
作者
George Papatheodoridis,Jiannis Vlachogiannakos,Εvangelos Cholongitas,Karsten Wursthorn,Christos Thomadakis,Giota Touloumi,Jörg Petersen
出处
期刊:Hepatology [Lippincott Williams & Wilkins]
卷期号:63 (5): 1481-1492 被引量:258
标识
DOI:10.1002/hep.28438
摘要

The possibility of safe discontinuation of therapy with nucleos(t)ide analogues (NAs) remains one of the most controversial topics in the management of chronic hepatitis B. Therefore, we systematically reviewed the existing data on NA discontinuation in this setting and tried to identify factors affecting the probability of posttherapy remission. A literature search was performed in order to identify all published studies including patients who discontinued NAs in virological remission (VR) and were followed for ≥12 months thereafter. Twenty-five studies with 1716 patients were included. The pooled rates of durable VR remission were 51.4%, 39.3%, and 38.2% at 12, 24, and 36 months, respectively, after NA discontinuation, being relatively higher in initially hepatitis B e antigen (HBeAg)-positive patients (62.5%, 53.4%, 51.5%) than HBeAg-negative patients (43.7%, 31.3%, 30.1%) (P = 0.064). The weighted probability of durable biochemical remission was 65.4%, being numerically higher in HBeAg-positive than HBeAg-negative patients (76.2% versus 56.7%, P = 0.130). The weighted probability of hepatitis B surface antigen loss was 2.0%. The rates of durable VR did not significantly differ according to the VR definition (hepatitis B virus DNA <200, < 2000, < 20,000 IU/mL) or duration of on-therapy VR in HBeAg-positive patients, but they were significantly higher in studies with HBeAg-negative patients and on-therapy VR > 24 than ≤ 24 months (VR at 12 months off-NAs: 75.0% versus 35.6%, P = 0.005). The weighted probability of durable HBeAg seroconversion was 91.9% and 88.0% at 12 and 24 months, respectively, after NA discontinuation without being affected by the duration of on-therapy VR or consolidation therapy (>6 months in all studies).Durable VR seems to be feasible in a substantial proportion of patients who discontinue long-term NA therapy; on-therapy VR > 24 months offers higher chances of off-NA VR in patients with HBeAg-negative chronic hepatitis B.
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
刚刚
HOPE发布了新的文献求助10
刚刚
AAA完成签到,获得积分10
2秒前
Singularity应助讨厌科研采纳,获得10
2秒前
古月发布了新的文献求助10
3秒前
4秒前
33发布了新的文献求助10
4秒前
汉堡包应助于平川春野采纳,获得10
4秒前
星星发布了新的文献求助10
6秒前
7秒前
赘婿应助十九岁的时差采纳,获得10
7秒前
怠惰vs勤劳完成签到,获得积分10
8秒前
夏天应助青山采纳,获得100
9秒前
10秒前
乖猫要努力应助潇湘雪月采纳,获得10
11秒前
wdy111举报风之星求助涉嫌违规
11秒前
古月完成签到,获得积分10
12秒前
12秒前
13秒前
吴所谓发布了新的文献求助50
16秒前
英吉利25发布了新的文献求助10
17秒前
18秒前
酷波er应助南冥采纳,获得10
18秒前
李沐唅完成签到 ,获得积分10
22秒前
lv完成签到,获得积分10
22秒前
周婷完成签到 ,获得积分10
23秒前
shy完成签到,获得积分10
23秒前
25秒前
犹豫的忆枫完成签到,获得积分10
25秒前
26秒前
夕沫发布了新的文献求助50
26秒前
勤奋大地发布了新的文献求助10
27秒前
乖猫要努力应助潇湘雪月采纳,获得10
27秒前
咚咚咚发布了新的文献求助30
29秒前
32秒前
赘婿应助栗子采纳,获得10
32秒前
西西发布了新的文献求助10
32秒前
坚定的琦完成签到 ,获得积分10
33秒前
任性的咖啡完成签到,获得积分20
33秒前
Hello应助zhao采纳,获得10
34秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
‘Unruly’ Children: Historical Fieldnotes and Learning Morality in a Taiwan Village (New Departures in Anthropology) 400
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
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 3989390
求助须知:如何正确求助?哪些是违规求助? 3531487
关于积分的说明 11254109
捐赠科研通 3270153
什么是DOI,文献DOI怎么找? 1804887
邀请新用户注册赠送积分活动 882087
科研通“疑难数据库(出版商)”最低求助积分说明 809174