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Stopping nucleos(t)ide analog treatment in chronic hepatitis b-Who and when?

Liver Research 2017年第2期1卷 135-139页

作者： Suzette Grace R.Kho-Herman Henry Lik-Yuen Chan Institute of Digestive Disease The Chinese University of Hong KongHong KongChina Makati Medical Center MakatiPhilippines

Nucleos(t)ide analogs(NAs)are one of the first-line treatments for chronic hepatitis b(CHb)*** are highly efficient in suppressing viral replication but are associated with a low rate of hepatitis b surface antigen(HbsAg)seroclearance and a high risk of post-treatment virologic *** a result,the optimal timing of NA cessation remains unclear,and long-term treatment is often *** international guidelines suggest that NA can be discontinued in hepatitis b e antigen(HbeAg)-positive patients who achieve HbeAg seroconversion with undetectable hepatitis b virus(HbV)DNA levels,the recommendations for discontinuing NA treatment in HbeAg-negative patients remain ***,there is no consensus regarding in whom and when to restart treatment among patients with hepatitis relapse after stopping NA *** studies suggest that virologic markers such as HbsAg and hepatitis b core-related antigen(HbcrAg)titers may be useful to guide when to stop NAs in CHb,since both markers appear to correlate with intrahepatic covalently closed circular HbV DNA ***,additional studies are required to refine their use.

关键词： hepatitis b Entecavir Tenofovir hepatitis b virus deoxyribonucleic acid (HbV DNA) hepatitis b surface antigen(HbsAg) hepatitis b core-related antigen(HbcrAg) hepatitis b e antigen(HbeAg)

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Association of Cytokines with Alanine Aminotransferase, hepatitis b virus Surface Antigen and hepatitis b Envelope Antigen Levels in Chronic hepatitis b

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Chinese Medical Journal 2018年第15期131卷 1813-1818页

作者： Ming-Hui Li Yao Lu Lu Zhang Xing-Yue Wang Chong-Ping Ran Hong-Xiao Hao Dan Zhang Xiao-Jing Qu Ge Shen Shu-Ling Wu Wei-Hua Cao Tian-Lin Qi Ru-Yu Liu Lei-Ping Hu Min Chang Wen-Hao Hua Shun-Ai Liu Gang Wan Yao Xie Liver Diseases Center Beijing Ditan Hospital Capital Medical University Beijing 100015 China beijing Key laboratory of Emerging Infectious Diseases Institute of Infectious Diseases Beijing Ditan Hospital Capital Medical University Beijing 100015 China Clinical Test Center Beijing Ditan Hospital Capital Medical University Beijing 100015 China Ming-Hui Li and Yao Lu contributed equally to this work

background： Cytokines play an important role in occorrence and recovery of hepatitis b virus （HbV） infection. The aim of this study was to investigate the changes ofcytokines concentration and its correlation to alanine aminotransferase （ALT）, HbV deoxyribonucleic acid （HbV-DNA）, hepatitis b envelope antigen （HbeAg）, and HbV surface antigen （HbsAg） in the development of chronic hepatitis b （CHb）. Methods： Thirteen healthy individuals （HI）, 30 chronic HbV-infected patients in immune tolerant （IT） phase, and 55 CHb patients were enrolled between August 2015 and May 2017. The peripheral blood samples were collected from all individuals. Tile levels of interferon （IFN）-α2, interleukin （IL）-10, transforming growth factor （TGF）-β1, HbV-DNA, HbsAg, and HbeAg and liver function were measured. The quantitative determinations of cytokines levels, including I FN-ct2, IL-10, and TGF-[31 were performed using Luminex multiplex technology. The correlation of cytokines to ALT, HbV-DNA, HbsAg, and HbeAg was analyzed by linear regression analysis. Results： IFN-ct2 levels were similar between HI and IT groups （15.35 [5.70, 67.65] pg/ml vs. 15.24 [4.07, 30.73] pg/ml, Z = -0.610, P - 0.542）, while it elevated significantly in CH b group （35.29 [ 15.94, 70.15] pg/ml vs. 15.24 [4.07, 30.73] pg/ml; Z = -2.522, P = 0.012）. Compared with HI group （3.73 [2.98, 11.92] pg/ml）, IL-10 concentrations in IT group （5.02 [2,98, 10.11] pg/ml）, and CHb group （7.48 [3. I 0, 18.00] pg/ml） slightly increased （X^2 = 2.015, P - 0.365）, and there was no significant difference between IT and CHb group （Z =- 1.419, P = 0.156）. The TGF-β1 levels among HI （3.59 ±0.20 pg/ml）, IT （3.62 ±0.55 pg/ml）, and CHb groups （3.64±0.30 pg/ml） were similar （X^2=2.739, P = 0.254）. In all chronic HbV-infected patients （including patients in IT and CHb groups）, the elevation of IFN-α2 level was significantly associated with ALT level （β = 0.389, t = 2.423, P = 0.018）, and was also negatively correlated to HbV-DNA load （β = -0.35

关键词： Chronic hepatitis b hepatitis b virus deoxyribonucleic acid hepatitis b virus Surface Antigen Intertferon-α2: lnterleukin- 10

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