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Anti-viral effect in chronic hepatitis B patients with normal or mildly elevated alanine aminotransferase.
Zhao, Qingqing; Liu, Kehui; Zhu, Xiaojun; Yan, Lei; Ding, Yezhou; Xu, Yumin; Lou, Shike; Zhao, Gangde; Xie, Qing; Gao, Yueqiu; Bao, Shisan; Wang, Hui.
Afiliação
  • Zhao Q; Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
  • Liu K; Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China; Department of Infectious Diseases, Ruijin North Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201801, China.
  • Zhu X; Department of Hepatopathy, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.
  • Yan L; Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
  • Ding Y; Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
  • Xu Y; Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
  • Lou S; Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
  • Zhao G; Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
  • Xie Q; Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
  • Gao Y; Department of Hepatopathy, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China. Electronic address: gaoyueqiu@hotmail.com.
  • Bao S; Discipline of Pathology, School of Medical Sciences, Charles Perkin Centre, Faculty of Medicine and Health, the University of Sydney, Sydney, Australia. Electronic address: bob.bao@sydney.edu.au.
  • Wang H; Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China. Electronic address: wanghuirj@163.com.
Antiviral Res ; 184: 104953, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33065138
ABSTRACT
BACKGROUND &

AIMS:

Normal/mildly elevated ALT (<2 × ULN) CHB patients are potentially at risk of progression to cirrhosis and/or hepatocellular carcinoma (HCC). We aimed to assess the outcomes of anti-viral therapy for normal/mild elevation of ALT CHB patients.

METHODS:

CHB patients (n = 432) who have had liver biopsied were determined. It was determined that the outcomes of anti-viral therapy in CHB patients with normal/mild elevation of ALT, in response to nucleoside/nucleotide analogues (NAs) (n = 190) and pegylated interferon (PEG-IFN) (n = 30) treatment for up to 72 weeks. Non-anti-viral treated patients were used as control (n = 40).

RESULTS:

There was about 50% of the CHB patients showed hepatic inflammatory necrosis ≥ G2 and/or fibrosis ≥ S2 among >30-years-old. The rate of undetectable HBV DNA in NAs and PEG-IFN groups was ~50%, ~80% or ~90% at week 24, 48 or 72, respectively. HBeAg clearance rate was lower in NAs treated than that in PEG-IFN group at week 48 (6% vs 20%, P < 0.05). ALT normalization rate was increased by 1.18-fold at week 72. HBsAg decline in HBeAg+ patients treated with NAs or PEG-IFN was 0.418 or 1.217 log IU/mL (P < 0.0001) at week 48; whereas HBsAg decline was 0.176 or 0.816 log IU/mL (P < 0.001) in HBeAg- patients. HBsAg at baseline and week 24 were strong predictors of "low HBsAg at week 48".

CONCLUSION:

Long term anti-viral therapy inhibits HBV replication effectively in ALT<2 × ULN CHB patients. PEG-IFN therapy is recommended for HBeAg+ patients with baseline HBsAg<4.37 log IU/ml and HBeAg- patients with baseline HBsAg<2.66 log IU/ml to achieve "low HBsAg at week 48".
Texto completo: Disponível Coleções: Bases de dados internacionais Contexto em Saúde: ODS3 - Saúde e Bem-Estar Tema em saúde: Meta 3.3: Acabar com as doenças tropicais negligenciadas e combater as doenças transmissíveis Base de dados: MEDLINE Tipo de estudo: Estudo prognóstico Idioma: Inglês Revista: Antiviral Res Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: China

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Texto completo: Disponível Coleções: Bases de dados internacionais Contexto em Saúde: ODS3 - Saúde e Bem-Estar Tema em saúde: Meta 3.3: Acabar com as doenças tropicais negligenciadas e combater as doenças transmissíveis Base de dados: MEDLINE Tipo de estudo: Estudo prognóstico Idioma: Inglês Revista: Antiviral Res Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: China