CAJ | 학술논문

目的：寻找并验证长期核苷类药物治疗获得病毒学应答慢性乙型肝炎患者 HBeAg 持续阳性的预测指标。方法以治疗基线 HBeAg阳性、长期核苷类药物治疗获得维持病毒学应答的慢性乙型肝炎患者为对象，分析治疗基线指标及首次病毒学应答后的 HBeAg效价对 HBeAg 持续阳性的预测价值。结果学习队列（n＝44，拉米夫定治疗）的患者首次病毒学应答后6个月的 HBeAg 效价可预测 HBeAg 持续阳性（ROC 曲线下面积＝0．875，P＝0．023）：HBeAg≥10．0 s/co（雅培Architect i2000检测）者不能清除 HBeAg的比例为64．0％（后续治疗时间24～33个月，中位数30）。验证队列（n＝171，恩替卡韦治疗）中，病毒学应答后6个月 HBeAg≥10．0 s/co 的患者88．0％持续 HBeAg 阳性，维持病毒学应答时间为15（6～51）个月。结论长期核苷类药物治疗 HBeAg阳性慢性乙型肝炎时虽可维持病毒学应答，但病毒学应答后6个月 HBeAg≥10．0 s/co的患者难以清除 HBeAg。
목적：심조병험증장기핵감류약물치료획득병독학응답만성을형간염환자 HBeAg 지속양성적예측지표。방법이치료기선 HBeAg양성、장기핵감류약물치료획득유지병독학응답적만성을형간염환자위대상，분석치료기선지표급수차병독학응답후적 HBeAg효개대 HBeAg 지속양성적예측개치。결과학습대렬（n＝44，랍미부정치료）적환자수차병독학응답후6개월적 HBeAg 효개가예측 HBeAg 지속양성（ROC 곡선하면적＝0．875，P＝0．023）：HBeAg≥10．0 s/co（아배Architect i2000검측）자불능청제 HBeAg적비례위64．0％（후속치료시간24～33개월，중위수30）。험증대렬（n＝171，은체잡위치료）중，병독학응답후6개월 HBeAg≥10．0 s/co 적환자88．0％지속 HBeAg 양성，유지병독학응답시간위15（6～51）개월。결론장기핵감류약물치료 HBeAg양성만성을형간염시수가유지병독학응답，단병독학응답후6개월 HBeAg≥10．0 s/co적환자난이청제 HBeAg。
Objective To identify and validate the potential parameters to predict HBeAg persistence in patients with virological response under long-term nucleoside analogues treatment. Methods HBeAg-positive patients with sustained virological response under long-term nucleoside analogues treatment were analyzed. Variables at baseline and HBeAg titers after first onset of undetectable viremia (FOUV)were adopted for further analysis. Results In study cohort (n= 44,lamivudine therapy),HBeAg levels in 6 months after FOUV could predict HBeAg persistence (AUROC= 0.874,P= 0.023). 64.0% patients with HBeAg titers ≥ 10.0 s/co at the time point failed to clear HBeAg [follow-up treatment lasted 30 (24-33)months]. This proportion was 88.0% in test cohort [n= 171,entecavir therapy, virological response maintenance was 1 5 (6-5 1 )months ]. Conclusions HBeAg could persist in most patients with HBeAg levels ≥ 10.0 s/co in 6 months after FOUV although virological responses are maintained under long-term nucleoside analogues therapy.