期刊论文详细信息
Kaohsiung Journal of Medical Sciences
Off-treatment efficacy of 3-year nucleos(t)ide analogues in chronic hepatitis B patients
Chih-Jen Chen1  Shee-Chan Lin1  Tai-Cherng Liou1  Tsang-En Wang1  Ming-Jen Chen1  Cheng-Hsin Chu1  Chia-Yuan Liu1  Shou-Chuan Shih1  Chen-Wang Chang1  Kuang-Chun Hu1  Ching-Chung Lin1  Horng-Yuan Wang1  Ming-Jong Bair2  Keng-Han Lee3 
[1] Division of Gastroenterology, Department of Internal Medicine and Liver Medical Center, Mackay Memorial Hospital, Taipei, Taiwan;Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taitung Branch, Taitung, Taiwan;Mackay Medical College, New Taipei City, Taiwan;
关键词: Alanine aminotransferase;    Entecavir;    Hepatitis B virus;    Lamivudine;    Telbivudine;   
DOI  :  10.1016/j.kjms.2015.11.005
来源: DOAJ
【 摘 要 】

Lamivudine, telbivudine, and entecavir are the first-line drugs covered by the Taiwan National Health Insurance as 3-year treatments for patients with chronic hepatitis B virus (HBV), but the optimal treatment duration of each remains unclear. We aimed to detect HBV treatment-cessation durability, and compare the predictors in patients with and without clinical relapse. In this retrospective cohort study, 210 patients with chronic HBV who tested hepatitis B e-antigen positive or hepatitis B e-antigen negative were treated for 3 years with a nucleos(t)ide analogue. Of these, 102 patients continued therapy after 3 years, while 88 patients stopped treatment and were followed for 1 year due to financial difficulties. Efficacy was assessed in terms of alanine aminotransferase (ALT) level normalization, HBV DNA clearance, virus breakthrough, clinical relapse, and liver decompensation. The durability predictors were evaluated by host factors, HBV DNA, and drug differences. Eighty patients (14 on lamivudine, 19 on telbivudine, and 47 on entecavir) were recruited. There was no difference in clinical-relapse rate among lamivudine, telbivudine, and entecavir (35.7% vs. 36.8% vs. 31.9%, respectively; p = 0.916), and liver decompensated hepatitis was absent. In baseline clinical characteristics, there were no differences between the clinical-relapse and nonrelapse groups in age, sex, cirrhosis, prior treatment, HBV DNA, pretreatment ALT, or hepatitis B e-antigen (HBeAg). The mean 3rd year serum ALT level differed significantly between clinical-relapse and nonrelapse patients (37.5 U/L vs. 27.7 U/L, respectively; p = 0.044). The 3-year nucleos(t)ide analogue off-treatment in patients with chronic HBV delivered according to the Taiwan National Health Insurance guidelines had an overall 33.8% 1-year clinical-relapse rate without any decompensated hepatitis flare-ups.

【 授权许可】

Unknown   

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