核苷(酸)类似物治疗慢性乙型肝炎患者HBV DNA阴转后HBsAg定量的变化

周友乾; 李翠; 尹凤鸣; 张海艳; 任彬; 阳薇

doi:10.3969/j.issn.1001-5256.2019.05.009

核苷(酸)类似物治疗慢性乙型肝炎患者HBV DNA阴转后HBsAg定量的变化

DOI: 10.3969/j.issn.1001-5256.2019.05.009

联勤保障部队第九二二医院暨湖南师范大学附属湘南医院感染内科

基金项目:

湖南省卫生计生委课题(C2016096)；

详细信息

中图分类号: R512.62
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出版历程
- 收稿日期: 2018-11-23
- 出版日期: 2019-05-20

Change in HBsAg quantification after HBV DNA negative conversion in chronic hepatitis B patients treated with nucleos (t) ide analogues

Department of Infectious Diseases, 922 Hospital of PLA & Xiangnan Hospital Affiliated to Hunan Normal University

Research funding:

摘要

摘要: 目的探讨核苷（酸）类似物治疗慢性乙型肝炎患者HBV DNA阴转后HBsAg定量变化。方法选取2016年1月-2018年11月在联勤保障部队第九二二医院暨湖南师范大学附属湘南医院感染内科予以核苷（酸）类似物规律治疗的慢性乙型肝炎患者,检测HBsAg定量和HBV DNA定量。HBV DNA阴转后HBsAg定量随治疗时间的分布差异采用χ2检验进行分析。结果共采集到275例患者的560次HBsAg定量结果。抗病毒治疗2年、3年、4年、5年和5年后,HBsAg <20 IU/ml的患者占比分别为1. 2%、4. 0%、3. 7%、4. 3%和9. 4%;<200 IU/ml的分别为9. 9%、13. 6%、17. 1%、23. 4%和30. 2%;<1000 IU/ml的分别为40. 7%、38. 8%、56. 1%、70. 2%和67. 9%;<1500 IU/ml的分别为59. 3%、64. 8%、73. 2%、76. 6%和79. 2%,差异均有统计学意义（χ2值分别为11. 186、21. 449、36. 341、27....
- 乙型肝炎,慢性 /
- 乙型肝炎表面抗原 /
- 核苷类 /
- 核苷酸类
Abstract: Objective To investigate the change in HBsAg quantification after HBV DNA negative conversion in chronic hepatitis B ( CHB) patients treated with nucleos ( t) ide analogues ( NAs) . Methods The CHB patients who were treated with NAs in Department of Infectious Diseases, 922 Hospital of PLA & Xiangnan Hospital Affiliated to Hunan Normal University, from January 2016 to November 2018 were enrolled. HBsAg quantitation and HBV DNA quantitation were measured. The chi-square test was used to investigate the difference in the distribution of HBsAg quantitation after HBV DNA negative conversion over the time of treatment. Results A total of 560 HBsAg quantification results were obtained from 275 patients. After 2, 3, 4, 5, and > 5 years of antiviral treatment, the proportion of patients with HBsAg< 20 IU/ml was 1. 2%, 4. 0%, 3. 7%, 4. 3%, and 9. 4%, respectively ( χ2= 11. 186, P = 0. 025) ; the proportion of patients with HBsAg < 200 IU/ml was 9. 9%, 13. 6%, 17. 1%, 23. 4%, and 30. 2%, respectively ( χ2= 21. 449, P < 0. 001) ; the proportion of patients with HBsAg < 1000 IU/ml was 40. 7%, 38. 8%, 56. 1%, 70. 2%, and 67. 9%, respectively ( χ2= 36. 341, P < 0. 001) ; the proportion of patients with HBsAg < 1500 IU/ml was 59. 3%, 64. 8%, 73. 2%, 76. 6%, and 79. 2%, respectively ( χ2= 27. 123, P < 0. 001) .Within 2 years of treatment, the HBeAg-negative patients had a significantly higher proportion of patients with HBsAg < 1000 IU/ml or <1500 IU/ml than the HBeAg-positive patients ( 45. 3%/64. 5% vs 22. 0%/38. 0%, χ2= 9. 039 and 11. 700, P = 0. 003 and 0. 001) . In the third year of treatment, the HBeAg-negative patients had a significantly higher proportion of patients with HBsAg < 1000 IU/ml or <1500 IU/ml than the HBeAg-positive patients ( 52. 6%/71. 1% vs 28. 6%/42. 9%, χ2= 5. 024 and 7. 617, P = 0. 025 and 0. 006) . Among the 162 patients who had multiple HBsAg quantitation tests, 66 had a gradual reduction in HBsAg quantitation, 47 had a gradual increase, and 49 had fluctuations in HBsAg quantitation, among whom 30 had a reduction in HBsAg quantitation from the first test to the last test and 19 had an increase in HBsAg quantitation. Conclusion After achieving virologic response to NAs, most CHB patients can reach the ideal threshold for combined or sequential interferon therapy by prolonged treatment, and some patients can even reach the ideal threshold for drug withdrawal; however, there are still some patients who may not reach the ideal endpoint even if the treatment is extended.
- hepatitis B, chronic /
- hepatitis B surface antigens /
- nucleosides /
- nucleotides

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参考文献(15)

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