单位：[1]Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing International Cooperation Base for Science and Technology On NAFLD Diagnosis, Peking University Hepatology Institute, Peking University People’s Hospital, Beijing 100044, China[2]Department of Hepatology Division, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China[3]Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China临床科室国家中心肝病分中心首都医科大学附属北京友谊医院[4]Complicated Liver Diseases and Artificial Liver Treatment and Training Center, Beijing Municipal Key Laboratory of Liver Failure and Artificial Liver Treatment and Research, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China[5]The Fifth Medical Center, Department of Infectious Diseases, General Hospital of PLA, Beijing 100039, China[6]Department of Infectious Diseases, Peking University First Hospital, Beijing 100034, China[7]Department of Infectious Diseases, The Second Hospital of Xingtai, Xingtai 054001, China[8]Department of Infectious Disease, China-Japan Friendship Hospital, Beijing, 100029, China[9]Department of Liver Disease, Tianjin Second People’s Hospital, Tianjin 300192, China[10]Department of Hepatopancreatobiliary Disease, School of Clinical Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, China[11]Department of Traditional and Western Medical Hepatology, The Third Hospital of Hebei Medical University, Shijiazhuang 050051, China[12]Department of Liver Disease, Shijiazhuang Fifth Hospital, Shijiazhuang 050021, China
Background Nucleos(t)ide analogues (NAs) cessation is not widely practiced and remains a controversial, but highly relevant subject in patients infected with hepatitis B virus (HBV). We aimed to explore the related factors for safe NAs cessation. Methods This is a multicenter prospective cohort study. Overall, 139 initially HBV e antigen (HBeAg)-positive patients meeting the stopping criteria were included in 12 hospitals in China. Enrolled patients ceased NAs and were followed up every 3 months for 24 months or until clinical relapse (CR). Results The 24 month cumulative rates of virological relapse (VR), CR, HBeAg reversion and HBV surface antigen (HBsAg) loss were 50.4, 24.5, 11.5 and 9.4%, respectively. Patients with end of treatment (EOT) HBsAg < 100 IU/mL plus negative HBV RNA had the lowest 24 month cumulative VR rate (5 vs 58%, p < 0.001). EOT HBsAg >= 2 log(10) IU/mL [odds ratio (OR) = 6.686, p = 0.006], EOT positive HBV RNA (OR = 3.453, p = 0.008) and EOT hepatitis B core-related antigen (HBcrAg) >= 4log U/mL (OR = 3.702, p = 0.002) were found to independently predict the risk of VR. To predict VR, the area under the receiver-operating characteristic (AUROC) value of the EOT HBsAg < 100 IU/mL plus EOT HBV RNA negative was 0.698 (p < 0.001), which was higher than other parameters alone or combinations. Conclusions NAs cessation is suitable only for a small and selected patients. An EOT HBsAg < 100 IU/mL and EOT negative HBV RNA identified a patient with low risk of off-treatment VR.
基金：
National Major Science and Technology Project of China [2017ZX10302201-004-001, 2017ZX10203202-003]; Beijing Municipal Science and Technology Commission of Major Projects [D161100002716002]; National Natural Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [82000557]; Peking University People's Hospital Research and Development Funds [RDY2020-12]
第一作者单位：[1]Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing International Cooperation Base for Science and Technology On NAFLD Diagnosis, Peking University Hepatology Institute, Peking University People’s Hospital, Beijing 100044, China
通讯作者：
推荐引用方式(GB/T 7714)：
Xie Yandi,Li Minghui,Ou Xiaojuan,et al.HBeAg-positive patients with HBsAg < 100 IU/mL and negative HBV RNA have lower risk of virological relapse after nucleos(t)ide analogues cessation[J].JOURNAL of GASTROENTEROLOGY.2021,56(9):856-867.doi:10.1007/s00535-021-01812-0.
APA：
Xie, Yandi,Li, Minghui,Ou, Xiaojuan,Zheng, Sujun,Gao, Yinjie...&Feng, Bo.(2021).HBeAg-positive patients with HBsAg < 100 IU/mL and negative HBV RNA have lower risk of virological relapse after nucleos(t)ide analogues cessation.JOURNAL of GASTROENTEROLOGY,56,(9)
MLA：
Xie, Yandi,et al."HBeAg-positive patients with HBsAg < 100 IU/mL and negative HBV RNA have lower risk of virological relapse after nucleos(t)ide analogues cessation".JOURNAL of GASTROENTEROLOGY 56..9(2021):856-867
医学