恩替卡韦治疗e抗原阴性慢性乙型肝炎停药后复发的分析

目的了解HBeAg阴性的慢性乙型肝炎(CHB)患者使用恩替卡韦抗病毒治疗的疗程及停药的标准。方法回顾性分析2006年1月至2015年12月复旦大学附属中山医院肝炎门诊确诊为HBeAg阴性的CHB并予恩替卡韦抗病毒治疗后停药6月以上的患者121例,观察其停药6个月、12个月的HBV DNA水平、肝功能。结果停药6个月后有33%的患者HBV DNA5×10~2拷贝/mL,19.8%患者出现ALT升高。停药12个月后累计有45.5%的患者HBV DNA5×10~2拷贝/mL,30.6%患者出现ALT升高,用药大于5年的患者复发率最低。此外,基线HBV DNA水平2×10~5拷贝/mL的患者停药后6个月、12个月的复发率较基线水平10~7拷贝/mL者低。结论 HBeAg阴性的CHB患者使用恩替卡韦治疗停药复发的比率随着抗病毒疗程的延长而减少,且基线HBV DNA水平与复发率相关。

Analysis of recurrence in HBeAg-negative chronic hepatitis B patients with entecavir withdrawal

Objective To evaluate the off-treatment efficacy of entecavir (ETV) therapy and to investigate the treatment and withdrawal standard of antiviral therapy for hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB) patients.Methods In the retrospective analysis,121 HBeAg negative CHB patients with ETV withdrawal for more than 6 months from January 2006 to December 2015 in our hospital were enrolled.Hepatitis B virus (HBV) DNA levels,liver function and HBV markers at month 6 and 12 after ETV withdrawal were measured.Results After ETV withdrawal,HBV DNA load was increased (＞5 × 102 copies/mL) in 33％ and 45.5％ patients at month 6 and 12,respectively,and alanine aminotransferase (ALT) was elevated in 19.8％ and 30.6％ patients.Patients with more than 5-year ETV administration had the lowest recurrence rate.In addition,HBV DNA load ＜2 × 105 copies/mL at baseline showed a lower recurrence rate at both month 6 and 12 after ETV withdrawal than the HBV DNA load ＞ 107 copies/ml at baseline.Conclusion The recurrence rate was negatively correlated with ETV treatment course in HBeAg-negative CHB patients,and positively correlated with the HBV DNA load at baseline.