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首页> 外文期刊>Hepatology: Official Journal of the American Association for the Study of Liver Diseases >Kinetics of hepatitis B surface antigen decline during 3 years of telbivudine treatment in hepatitis B e antigen-positive patients.
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Kinetics of hepatitis B surface antigen decline during 3 years of telbivudine treatment in hepatitis B e antigen-positive patients.

机译：替比夫定治疗3年后，乙肝e抗原阳性患者的乙肝表面抗原动力学下降。

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摘要

The impact of prolonged direct antiviral therapy on hepatitis B surface antigen (HBsAg) levels in patients with chronic hepatitis B is poorly understood. We quantitatively assessed serum HBsAg levels during 3 years of telbivudine treatment, as well as their relationship with virologic and biochemical characteristics in 162 hepatitis B e antigen-positive patients who maintained undetectable serum hepatitis B virus (HBV) DNA long-term. Telbivudine treatment progressively reduced serum HBsAg levels (mean +/- SD) from baseline (3.8 +/- 0.6 log IU/mL) to treatment week 24 (3.4 +/- 0.7 log IU/mL), treatment year 1 (3.3 +/- 0.8 log IU/mL), and treatment year 3 (3.0 +/- 1.4 log IU/mL) (P <0.0001). In this patient population, HBsAg loss was observed in nine (6%) of 162 patients through year 3. During the first year of treatment, three patterns of HBsAg decline were observed: rapid (>/= 1 log IU/mL) in 32 patients, slow (0-1 log IU/mL) in 74 patients, and steady levels in 56 patients. These findings were associated with different likelihoods of HBsAg loss during long-term telbivudine therapy. Eight of 32 patients with rapid HBsAg decline versus none of 56 patients with steady HBsAg levels achieved HBsAg loss at year 3 (P = 0.0024). HBV genotype was a significant determinant for HBsAg kinetics, with the fastest decline in genotype A patients. In patients with subsequent HBsAg loss, viral antigens were already undetectable in liver biopsy samples after 1 year of treatment. This was associated with markedly enhanced antiviral T cell reactivity. CONCLUSION: In patients who have effective suppression of viral replication during telbivudine treatment, a rapid decline in serum HBsAg levels during the first year may identify those with a greater likelihood of achieving HBsAg clearance.
机译：长期直接抗病毒治疗对慢性乙型肝炎患者的乙型肝炎表面抗原（HBsAg）水平的影响知之甚少。我们定量评估了替比夫定治疗3年期间的血清HBsAg水平，以及它们与162例长期无法检测的血清B型肝炎病毒（HBV）DNA的乙型肝炎e抗原阳性患者的病毒学和生化特征之间的关系。替比夫定治疗从基线（3.8 +/- 0.6 log IU / mL）到治疗第24周（3.4 +/- 0.7 log IU / mL）逐渐降低血清HBsAg水平（平均值+/- SD），治疗第一年（3.3 + / -0.8 log IU / mL）和治疗第3年（3.0 +/- 1.4 log IU / mL）（P <0.0001）。在该患者人群中，到第3年为止，在162名患者中有9名（6％）观察到HBsAg下降。在治疗的第一年，观察到HBsAg下降的三种模式：在32名患者中快速（> / = 1 log IU / mL）患者，其中74例患者缓慢（0-1 log IU / mL），而56例患者水平稳定。这些发现与长期替比夫定治疗期间HBsAg丢失的不同可能性相关。在第3年，HBsAg迅速下降的32例患者中有8例，而稳定HBsAg水平的56例患者中没有1例达到HBsAg丢失（P = 0.0024）。 HBV基因型是决定HBsAg动力学的重要因素，而基因型A患者的下降最快。在随后的HBsAg丢失的患者中，治疗1年后，肝活检样本中已检测不到病毒抗原。这与抗病毒T细胞反应性明显增强有关。结论：在替比夫定治疗期间有效抑制病毒复制的患者中，第一年血清HBsAg水平快速下降可能会发现那些获得HBsAg清除率更高的可能性。

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