{"title":"慢性乙型肝炎患者核苷类似物抗病毒治疗安全停药的预测标志物","authors":"X. Miao, B. Pei","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.12.002","DOIUrl":null,"url":null,"abstract":"对核苷类药物抗乙型肝炎病毒(hepatitis B virus，HBV)治疗后能否安全停药的问题提出一些看法：①在乙型肝炎e抗原(hepatitis B e antigen，HBeAg)阳性的慢性乙型肝炎(chronic hepatitis B，CHB)患者中，HBV DNA低于检测下限、丙氨酸转氨酶复常、HBeAg血清学转换；在HBeAg阴性CHB患者中，HBV DNA不可测、转氨酶复常，是停药的最基本条件。②某些临床参数，如HBV感染途径、初始抗病毒治疗时的年龄和血液HBV DNA载量、HBV DNA达到不可测的时间、既往抗病毒用药情况等，停药时均可作为参考。③乙型肝炎表面抗原(hepatitis B surface antigen，HBsAg)消失伴或不伴血清学转换是停药的理想标准，但血清HBsAg水平与HBV复制和共价闭合环状DNA(covalently closed circular DNA，cccDNA)不完全相关。④肝组织HBV cccDNA的消失代表HBV被清除，但因检测技术因素的限制，尚不能成为停药标准应用于临床。⑤血清HBV RNA有望成为监测抗病毒疗效和安全停药的新型生物标志物。","PeriodicalId":10127,"journal":{"name":"中华传染病杂志","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Predictive markers for safe discontinuation of nucleos(t)ide analogues antiviral therapy in chronic hepatitis B patients\",\"authors\":\"X. Miao, B. Pei\",\"doi\":\"10.3760/CMA.J.ISSN.1000-6680.2019.12.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"对核苷类药物抗乙型肝炎病毒(hepatitis B virus，HBV)治疗后能否安全停药的问题提出一些看法：①在乙型肝炎e抗原(hepatitis B e antigen，HBeAg)阳性的慢性乙型肝炎(chronic hepatitis B，CHB)患者中，HBV DNA低于检测下限、丙氨酸转氨酶复常、HBeAg血清学转换；在HBeAg阴性CHB患者中，HBV DNA不可测、转氨酶复常，是停药的最基本条件。②某些临床参数，如HBV感染途径、初始抗病毒治疗时的年龄和血液HBV DNA载量、HBV DNA达到不可测的时间、既往抗病毒用药情况等，停药时均可作为参考。③乙型肝炎表面抗原(hepatitis B surface antigen，HBsAg)消失伴或不伴血清学转换是停药的理想标准，但血清HBsAg水平与HBV复制和共价闭合环状DNA(covalently closed circular DNA，cccDNA)不完全相关。④肝组织HBV cccDNA的消失代表HBV被清除，但因检测技术因素的限制，尚不能成为停药标准应用于临床。⑤血清HBV RNA有望成为监测抗病毒疗效和安全停药的新型生物标志物。\",\"PeriodicalId\":10127,\"journal\":{\"name\":\"中华传染病杂志\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2019-12-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"中华传染病杂志\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.12.002\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"中华传染病杂志","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.12.002","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
Some opinions are proposed on whether nucleoside drugs can safely discontinue treatment against hepatitis B virus (HBV): ① In chronic hepatitis B (CHB) patients with positive hepatitis B e antigen (HBeAg), HBV DNA is below the detection limit, alanine aminotransferase is normalized, and HBeAg serological conversion; In HBeAg negative CHB patients, undetectable HBV DNA and normalization of transaminases are the most basic conditions for discontinuation of medication Some clinical parameters, such as the route of HBV infection, age and blood HBV DNA load at the time of initial antiviral treatment, the time when HBV DNA reaches an undetectable level, and previous antiviral medication, can be used as references when discontinuing medication The disappearance of hepatitis B surface antigen (HBsAg) with or without serological conversion is an ideal standard for discontinuation, but serum HBsAg levels are not fully correlated with HBV replication and covalent closed circular DNA (cccDNA) The disappearance of HBV cccDNA in liver tissue represents the clearance of HBV, but due to limitations in detection technology, it cannot be used as a withdrawal standard for clinical use. ⑤ Serum HBV RNA is expected to become a new biomarker for monitoring antiviral efficacy and safe discontinuation of drugs.
Predictive markers for safe discontinuation of nucleos(t)ide analogues antiviral therapy in chronic hepatitis B patients
对核苷类药物抗乙型肝炎病毒(hepatitis B virus，HBV)治疗后能否安全停药的问题提出一些看法：①在乙型肝炎e抗原(hepatitis B e antigen，HBeAg)阳性的慢性乙型肝炎(chronic hepatitis B，CHB)患者中，HBV DNA低于检测下限、丙氨酸转氨酶复常、HBeAg血清学转换；在HBeAg阴性CHB患者中，HBV DNA不可测、转氨酶复常，是停药的最基本条件。②某些临床参数，如HBV感染途径、初始抗病毒治疗时的年龄和血液HBV DNA载量、HBV DNA达到不可测的时间、既往抗病毒用药情况等，停药时均可作为参考。③乙型肝炎表面抗原(hepatitis B surface antigen，HBsAg)消失伴或不伴血清学转换是停药的理想标准，但血清HBsAg水平与HBV复制和共价闭合环状DNA(covalently closed circular DNA，cccDNA)不完全相关。④肝组织HBV cccDNA的消失代表HBV被清除，但因检测技术因素的限制，尚不能成为停药标准应用于临床。⑤血清HBV RNA有望成为监测抗病毒疗效和安全停药的新型生物标志物。
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