中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 37 Issue 5
May  2021
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2021  >  37(5): 1047-1052

Dynamic changes of HBsAg and hepatitis B virus DNA in chronic hepatitis B patients with entecavir monotherapy for 5 years

DOI: 10.3969/j.issn.1001-5256.2021.05.015
  • a.

    Department of Infectious Diseases, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China

  • b.

    Department of Clinical Laboratory, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China

  • Received Date: 2020-10-20
  • Accepted Date: 2021-01-27
  • Published Date: 2021-05-20
    Abstract
  •   Objective  To investigate the dynamic changes of serum HBsAg and hepatitis B virus (HBV) DNA in chronic hepatitis B patients (CHB) with entecavir (ETV) monotherapy for 5 years.  Methods  A retrospective analysis was performed for the clinical data of 918 CHB patients who attended the Second Affiliated Hospital of Xi'an Jiaotong University from January 2012 to August 2020 and received ETV monotherapy for ≥5 years, among whom 556 had positive HBeAg and 362 had negative HBeAg at initial treatment. Serum HBsAg level and HBV DNA load at baseline and at 1, 2, 3, 4, and 5 years of treatment were collected to analyze their dynamic changes. The t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; log10 logarithmic transformation was performed for non-normally distributed repeated measurement data, and then a repeated-measures analysis of variance was used for comparison between groups or within each group; the chi-square test was used for comparison of categorical data between two groups.  Results  Both HBeAg-positive and HBeAg-negative patients had a significant reduction in HBsAg level over the time of ETV treatment (F=174.168 and 49.845, both P < 0.001). The HBeAg-positive patients had a baseline HBsAg level of 18 043.1 (7868.9-26 342.4) IU/ml, which significantly decreased to 1397.6 (626.4-3419.4) IU/ml after 5 years of ETV treatment (P < 0.001); the HBeAg-positive patients had a baseline HBV DNA load of (6.7±1.7) log10 IU/ml and achieved an HBV DNA clearance rate of 100% after 5 years of ETV treatment. The HBeAg-negative patients had a baseline HBsAg level of 2420.0 (662.6-5621.2) IU/ml, which significantly decreased to 407.2 (56.7-1104.7) IU/ml after 5 years of ETV treatment (P < 0.001); the HBeAg-negative patients had a baseline HBV DNA load of 4.9±1.4 log10 IU/ml and achieved an HBV DNA clearance rate of 100% after 5 years of ETV treatment. The HBeAg-positive patients had a significantly higher median HBsAg level than the HBeAg-negative patients at each time point (all P < 0.001). Both HBeAg-positive and HBeAg-negative patients showed a changing trend of rapid reduction followed by slow reduction in HBsAg, and the mean annual rate of reduction in HBsAg in the first 2 years of ETV treatment was significantly higher than that in the last 3 years of ETV treatment (HBeAg-positive: Z=-13.605, P < 0.001; HBeAg-negative: Z=-5.950, P < 0.001). The HBeAg-positive patients had a significantly lower HBV DNA clearance rate than the HBeAg-negative patients at 1 year of ETV treatment (χ2=71.013, P < 0.001), and both HBeAg-positive and HBeAg-negative patients achieved an HBV DNA clearance rate of 100% at 2, 3, 4, and 5 years of treatment. After 5 years of ETV treatment, the cumulative proportions of patients with HBsAg clearance, HBsAg < 200 IU/ml, HBsAg < 1000 IU/ml, and HBsAg < 1500 IU/ml were 3.6%, 23.9%, 57.0%, and 67.3%, respectively.  Conclusion  During the EVT treatment of CHB, the levels of HBsAg and HBV DNA gradually decrease, and the level of HBsAg shows a trend of rapid reduction followed by slow reduction. After 5 years of ETV monotherapy, 67.3% of the patients can achieve an HBsAg level of < 1500 IU/ml.

     

    • FullText(HTML)
  • loading
    • References(16)
  • [1]
    Chinese Society of Infectious Diseases, Chinese Medical Association; Chinese Society of Hepatology, Chinese Medical Association. Guidelines for the prevention and treatment of chronic hepatitis B (version 2019)[J]. J Clin Hepatol, 2019, 35(12): 2648-2669. DOI: 10.3969/j.issn.1001-5256.2019.12.007.

    中华医学会感染病学分会, 中华医学会肝病学分会. 慢性乙型肝炎防治指南(2019年版)[J]. 临床肝胆病杂志, 2019, 35(12): 2648-2669. DOI: 10.3969/j.issn.1001-5256.2019.12.007.
    [2]
    ZHAO Y, LI Y, QI L, et al. Antiviral curative effects of tenofovir and entecavir in treatment of aged patients with chronic hepatitis B and their regulation on inflammation factors[J]. J Jilin Univ(Med Edit), 2019, 45(1): 117-122. DOI: 10.13481/j.1671-587x.20190122.

    赵阳, 李烨, 齐玲, 等. 替诺福韦酯和恩替卡韦治疗老年慢性乙型肝炎患者的抗病毒疗效及对致炎细胞因子的调节作用[J]. 吉林大学学报(医学版), 2019, 45(1): 117-122. DOI: 10.13481/j.1671-587x.20190122.
    [3]
    LIN L, LIU JY, DENG H, et al. Influencing factors of partial virological response to entecavir monotherapy of patients with chronic hepatitis B[J/CD]. Chin J Liver Dis(Electronic Edition), 2019, 11(4): 81-84. DOI: 10.3969/j.issn.1674-7380.2019.04.013.

    林丽, 刘俊英, 邓慧, 等. 恩替卡韦单药治疗慢性乙型肝炎患者部分病毒学应答的影响因素[J/CD]. 中国肝脏病杂志(电子版), 2019, 11(4): 81-84. DOI: 10.3969/j.issn.1674-7380.2019.04.013.
    [4]
    XU Y, ZHANG YG, WANG X, et al. Long-term antiviral efficacy of entecavir and liver histology improvement in Chinese patients with hepatitis B virus-related cirrhosis[J]. World J Gastroenterol, 2015, 21(25): 7869-7876. DOI: 10.3748/wjg.v21.i25.7869.
    [5]
    SETO WK, WONG DK, FUNG J, et al. Reduction of hepatitis B surface antigen levels and hepatitis B surface antigen seroclearance in chronic hepatitis B patients receiving 10 years of nucleoside analogue therapy[J]. Hepatology, 2013, 58(3): 923-931. DOI: 10.1002/hep.26376.
    [6]
    FAN XX, CUI FM, WANG FS, et al. Analysis of the characteristics and influencing factors of HBsAg change in chronic hepatitis B patients treated with NAs[J]. Acta Acad Med Bengbu, 2019, 44(5): 582-584, 589. DOI: 10.13898/j.cnki.issn.1000-2200.2019.05.005.

    范新星, 崔甫朦, 王福生, 等. NAs治疗慢性乙型肝炎后HBsAg变化的特点和影响因素分析[J]. 蚌埠医学院学报, 2019, 44(5): 582-584, 589. DOI: 10.13898/j.cnki.issn.1000-2200.2019.05.005.
    [7]
    XI HL, LI MR, BAO Y, et al. Antiviral dynamic change of HBV DNA and HBsAg and significance of quarterly and annual quantitative measurements over 5 years follow up of chronic hepatitis B patient[J]. Chin J Hepatol, 2013, 21(11): 821-824. DOI: 10.3760/cma.j.issn.1007-3418.2013.11.006.

    席宏丽, 李敏然, 鲍毅, 等. 核苷(酸)类抗病毒药物治疗慢性乙型肝炎患者HBV DNA与HBsAg定量的5年动态分析[J]. 中华肝脏病杂志, 2013, 21(11): 821-824. DOI: 10.3760/cma.j.issn.1007-3418.2013.11.006.
    [8]
    CHU CJ, HUSSAIN M, LOK AS. Quantitative serum HBV DNA levels during different stages of chronic hepatitis B infection[J]. Hepatology, 2002, 36(6): 1408-1415. DOI: 10.1053/jhep.2002.36949.
    [9]
    HSU WF, CHEN CF, LAI HC, et al. Trajectories of serum hepatitis B surface antigen kinetics in patients with chronic hepatitis B receiving long-term nucleos(t)ide analogue therapy[J]. Liver Int, 2018, 38(4): 627-635. DOI: 10.1111/liv.13564.
    [10]
    European Association for the Study of the Liver. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection[J]. J Hepatol, 2017, 67(2): 370-398. DOI: 10.1016/j.jhep.2017.03.021.
    [11]
    TAN L, WU T, LV Y, et al. HBsAg levels normalized to the same hepatic parenchyma cell volume is correlated with pathological progression but not HBeAg status[J]. J Sun Yat-Sen Univ(Medical Sciences), 2019, 40(5): 747-753. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2019.0104.

    谭雷, 吴涛, 吕艳, 等. 经相同肝实质细胞体积分摊的血清HBsAg水平与肝组织病理进展相关而与HBeAg状态无关[J]. 中山大学学报(医学科学版), 2019, 40(5): 747-753. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2019.0104.
    [12]
    CHEN CH, LU SN, HUNG CH, et al. The role of hepatitis B surface antigen quantification in predicting HBsAg loss and HBV relapse after discontinuation of lamivudine treatment[J]. J Hepatol, 2014, 61(3): 515-522. DOI: 10.1016/j.jhep.2014.04.029.
    [13]
    SETO WK, LIU K, WONG DK, et al. Patterns of hepatitis B surface antigen decline and HBV DNA suppression in Asian treatment-experienced chronic hepatitis B patients after three years of tenofovir treatment[J]. J Hepatol, 2013, 59(4): 709-716. DOI: 10.1016/j.jhep.2013.06.007.
    [14]
    CHEN JL, YUAN ZH. Influence of interferon and nucleos(t)ide analogues on HBV cccDNA and functional cure of chronic hepatitis B[J]. J Clin Hepatol, 2019, 35(6): 1181-1187. DOI: 10.3969/j.issn.1001-5256.2019.06.002.

    陈捷亮, 袁正宏. 干扰素和核苷(酸)类似物治疗对HBV cccDNA的影响与慢性乙型肝炎的功能性治愈[J]. 临床肝胆病杂志, 2019, 35(6): 1181-1187. DOI: 10.3969/j.issn.1001-5256.2019.06.002.
    [15]
    Chinese Medical Association, Chinese Society of Infectious Disease, Chinese Society of Hepatology, Chinese Medical Association. The expert consensus on clinical cure (functional cure) of chronic hepatitis B[J]. J Clin Hepatol, 2019, 35(8): 1693-1701. DOI: 10.3969/j.issn.1001-5256.2019.08.008.

    中华医学会感染病学分会, 中华医学会肝病学分会. 慢性乙型肝炎临床治愈(功能性治愈)专家共识[J]. 临床肝胆病杂志, 2019, 35(8): 1693-1701. DOI: 10.3969/j.issn.1001-5256.2019.08.008.
    [16]
    ZHOU YQ, LI C, YIN FM, et al. Change in HBsAg quantification after HBV DNA negative conversion in chronic hepatitis B patients treated with nucleos(t)ide analogues[J]. J Clin Hepatol, 2019, 35(5): 977-981. DOI: 10.3969/j.issn.1001-5256.2019.05.009.

    周友乾, 李翠, 尹凤鸣, 等. 核苷(酸)类似物治疗慢性乙型肝炎患者HBV DNA阴转后HBsAg定量的变化[J]. 临床肝胆病杂志, 2019, 35(5): 977-981. DOI: 10.3969/j.issn.1001-5256.2019.05.009.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(2)  / Tables(5)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (672) PDF downloads(143) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return