停核后的乙型肝炎表面抗原血清清除率 在慢性乙型肝炎中的t) 类同类-A系统性审查和元分析
Soe Thiha Maung1,2, Pakanat Decharatanachart1,3, Roongruedee Chaiteerakij1,4
1Division of Gastroenterology, Department of Medicine, King Chulalongkorn Memorial Hospital and Thai Red Cross Society, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Journal of gastroenterology and hepatology
|March 5, 2025
概括
乙型肝炎患者停止核胺类同类疗法,其HBsAg血清清除的可能性为10%. 诸如种族,HBeAg状态和随访时间等因素显著影响结果,指导个性化治疗策略.
科学领域:
- 肝病学和病毒性肝炎研究研究
- 病毒感染的免疫学
- 药物治疗和治疗结果
背景情况:
- 慢性乙型肝炎 (CHB) 的治疗包括核胺类比 (NA) 疗法.
- 停止NA治疗的目的是HBsAg血清清除,这是治疗的关键目标.
- 在NA停止后预测HBsAg血清清除对于个性化患者管理至关重要.
研究的目的:
- 在CHB患者中停止NA治疗后,确定影响HBsAg血清率的关键因素.
- 为优化NA停产策略提供基于证据的见解.
- 突出未来研究领域,以预测HBV治疗结果.
主要方法:
- 一个全面的分析到2024年7月出版的文献.
- 包括62项研究,其中9867名患者正在接受NA终止.
- 亚组分析和元回归以评估诸如种族,HBV基因型,NA持续时间,EOT qHBsAg,HBeAg状态,肝硬化和随访持续时间等因素.
主要成果:
- 汇总的HBsAg血清清除率为10% (95% CI:8%-12%).
- 在HBeAg阴性患者 (11%对5%),随访时间较长 (>5年;18%) 和治疗结束 (EOT) qHBsAg水平较低 (≤2.0 log IU/mL;23%) 中观察到更高的发病率.
- 种族 (白人12%,亚洲人9%) 和随访时间是异质性的重要因素.
结论:
- 种族,EOT qHBsAg水平,HBeAg状态和随访时间是NA治疗后HBsAg血清清除的关键决定因素.
- 需要个性化的NA停产策略,考虑到已识别的影响因素.
- 需要对HBV基因型和新生物标志物的进一步研究,以改善血清清除的预测.
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