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Combining Hepatitis B Virus RNA and Hepatitis B Core-Related Antigen: Guidance for Safely Stopping Nucleos(t)ide Analogues in Hepatitis B e Antigen-Positive Patients With Chronic Hepatitis B

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单位: [1]Southern Med Univ, Nanfang Hosp, Guangdong Prov Key Lab Viral Hepatitis Res, State Key Lab Organ Failure Res,Dept Infect Dis, Guangzhou, Peoples R China [2]Shanghai Jiao Tong Univ, Ruijin Hosp, Dept Infect Dis, Sch Med, Shanghai, Peoples R China [3]Cent South Univ, Xiangya Hosp, Dept Infect Dis, Changsha, Peoples R China [4]Eighth Peoples Hosp, Guangzhou, Peoples R China [5]Jilin Univ, Hepatol Unit, 1 Hosp, Changchun, Peoples R China [6]Peking Univ Peoples Hosp, Hepatol Unit, Beijing, Peoples R China [7]Chongqing Med Univ, Affiliated Hosp 2, Dept Infect Dis, Chongqing, Peoples R China [8]Beijing Youan Hosp, Beijing, Peoples R China [9]81st PLA Hosp, Dept Infect Dis, Nanjing, Peoples R China [10]Zhejiang Univ, Dept Infect Dis, Affiliated Hosp 1, Hangzhou, Peoples R China [11]West China Hosp, Dept Infect Dis, Chengdu, Peoples R China [12]Tangdu Hosp, Dept Infect Dis, Xian, Peoples R China
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关键词: discontinuation clinical relapse HBsAg loss biomarker

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Background. Safe nucleos(t)ide analogue discontinuation in chronic hepatitis B (CHB) is an unmet need. We aimed to investigate whether combining hepatitis B virus (HBV) RNA and hepatitis B core-related antigen (HBcrAg) could perform satisfactorily in predicting off-treatment outcomes. Methods. The evaluation cohort included 127 hepatitis B e antigen (HBeAg)-positive patients from a multicenter prospective trial who stopped telbivudine-based therapy after achieving HBeAg seroconversion and HBV DNA<50 IU/mL for>48 weeks. As validation, 59 patients treated with entecavir or tenofovir before discontinuation were analyzed. Results. At the end of treatment (EOT), HBV RNA and HBcrAg were significant independent predictors of the clinical relapse risk. In the evaluation cohort, no clinical relapse occurred among patients with negative HBV RNA and HBcrAg<4 log(10) U/mL at EOT (low-risk group), whereas 46.8% patients with positive HBV RNA and HBcrAg >= 4 log(10) U/mL (high-risk group) experienced clinical relapse during 4-year posttreatment follow-up (P < .001); the corresponding incidences in the validation cohort were 0% and 69.4% (P < .001), respectively. More patients in the low-risk group achieved HBsAg loss than the other patients after treatment cessation (16.1% vs 1.3%, P = .002). Conclusions. Combining HBV RNA and HBcrAg performed satisfactorily in predicting clinical relapse and HBsAg loss after treatment cessation in HBeAg-positive patients with CHB.

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出版当年[2019]版:
大类 | 2 区 医学
小类 | 2 区 免疫学 2 区 传染病学 2 区 微生物学
最新[2025]版:
大类 | 2 区 医学
小类 | 2 区 免疫学 2 区 传染病学 2 区 微生物学
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出版当年[2018]版:
Q1 MICROBIOLOGY Q1 IMMUNOLOGY Q1 INFECTIOUS DISEASES
最新[2023]版:
Q1 INFECTIOUS DISEASES Q1 MICROBIOLOGY Q2 IMMUNOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2018版] 出版当年五年平均 出版前一年[2017版] 出版后一年[2019版]

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第一作者单位: [1]Southern Med Univ, Nanfang Hosp, Guangdong Prov Key Lab Viral Hepatitis Res, State Key Lab Organ Failure Res,Dept Infect Dis, Guangzhou, Peoples R China
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通讯机构: [1]Southern Med Univ, Nanfang Hosp, Guangdong Prov Key Lab Viral Hepatitis Res, State Key Lab Organ Failure Res,Dept Infect Dis, Guangzhou, Peoples R China [*1]Southern Med Univ, Nanfang Hosp, Dept Infect Dis, Guangzhou 510515, Peoples R China
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