摘要
Abstract
OBJECTIVE:To study the persistence of the effects of nucleoside (acid) analogues in the treatment of chronic hepatitis B (CHB) after drug withdrawal. METHODS:150 cases of CHB were selected and received nucleoside (acid) ana-logues for one year at least. They were divided into the standard group(n=56)and non standard group(n=87)according to the drug withdrawal standard stated in Guidelines for Prevention and Treatment of CHB,and followed up for one year except 7 cas-es of drug withdrawal who were followed up less than one year. HBV serum markers HBVM and HBV-DNA were detected quan-titatively in 2 groups. CHB recurrence,HBsAg disappearance and the change of HBV in serum were observed in 2 groups after drug withdrawal. RESULTS:The recurrence rate of CHB patients with HBeAg (+) in standard group and non standard group were lower than those with HBeAg(-),with statistical significance(P<0.01 or P<0.05);that of CHB patients with HBeAg (+) in standard group was lowe than those with HBeAg (+) in non standard group,with statistical significance (P<0.05);there was no statistical significance in recurrence rate of CHB patients with HBeAg(-)between standard group and non stan-dard group(P>0.05);the total recurrence rate of standard group was lower than that of non standard group,with statistical sig-nificance(P<0.05). There was no statistical significance in recurrence rate between 2 groups after drug withdrawal following 4 kinds of nucleoside (acid) analogue monotherapy (P>0.05). Among sustained responders,HBsAg of 3 patients disappeared in standard group,including 2 cases of HBsAg seroconversion,1 case of no HBsAg seroconversion. Among patients with recurrent CHB,2 patients suffered from HBeAg(+)again in standard group,and 1 patient with HBeAg(-)developed liver cancer;5 patients suffered from HBeAg(+)again in non standard group,including 1 patient died and 1 patient with HBeAg(-)devel-oped liver cancer. CONCLUSIONS:Taking Guidelines for Prevention and Treatment of CHB as drug withdrawal standard,there still is a high recurrence rate after stopping nucleoside(acid)analogues;the recurrence rate of patients with HBeAg(-)is high-er than those with HBeAg(+),and that of patients in non standard group is higher than in standard group. The types of nucleo-side(acid)analogues do not influence recurrence rate after drug withdrawal.关键词
核苷(酸)类似物/停药/慢性乙型肝炎/药效/持久性Key words
Nucleoside(acid)analogues/Drug withdrawal/Chronic hepatitis B/Effect/Persistence分类
医药卫生
