Hepatitis B surface antigen titer is a good indicator of durable viral response after entecavir off-treatment for chronic hepatitis B
Background/Aims Clear indicators for stopping antiviral therapy in chronic hepatitis B (CHB) patients are not yet available. Since the level of hepatitis B surface antigen (HBsAg) is correlated with covalently closed circular DNA, the HBsAg titer might be a good indicator of the off-treatment respon...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Association for the Study of the Liver
2016-09-01
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| Series: | Clinical and Molecular Hepatology |
| Subjects: | |
| Online Access: | http://e-cmh.org/upload/pdf/cmh-2016-0047.pdf |
| _version_ | 1818244311925391360 |
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| author | Han Ah Lee Yeon Seok Seo Seung Woon Park Sang Jung Park Tae Hyung Kim Sang Jun Suh Young Kul Jung Ji Hoon Kim Hyunggin An Hyung Joon Yim Jong Eun Yeon Kwan Soo Byun Soon Ho Um |
| author_facet | Han Ah Lee Yeon Seok Seo Seung Woon Park Sang Jung Park Tae Hyung Kim Sang Jun Suh Young Kul Jung Ji Hoon Kim Hyunggin An Hyung Joon Yim Jong Eun Yeon Kwan Soo Byun Soon Ho Um |
| author_sort | Han Ah Lee |
| collection | DOAJ |
| description | Background/Aims Clear indicators for stopping antiviral therapy in chronic hepatitis B (CHB) patients are not yet available. Since the level of hepatitis B surface antigen (HBsAg) is correlated with covalently closed circular DNA, the HBsAg titer might be a good indicator of the off-treatment response. This study aimed to determine the relationship between the HBsAg titer and the entecavir (ETV) off-treatment response. Methods This study analyzed 44 consecutive CHB patients (age, 44.6±11.4 years, mean±SD; men, 63.6%; positive hepatitis B envelope antigen (HBeAg) at baseline, 56.8%; HBV DNA level, 6.8±1.3 log10 IU/mL) treated with ETV for a sufficient duration and in whom treatment was discontinued after HBsAg levels were measured. A virological relapse was defined as an increase in serum HBV DNA level of >2000 IU/mL, and a clinical relapse was defined as a virological relapse with a biochemical flare, defined as an increase in the serum alanine aminotransferase level of >2 × upper limit of normal. Results After stopping ETV, virological relapse and clinical relapse were observed in 32 and 24 patients, respectively, during 20.8±19.9 months of follow-up. The cumulative incidence rates of virological relapse were 36.2% and 66.2%, respectively, at 6 and 12 months, and those of clinical relapse were 14.3% and 42.3%. The off-treatment HBsAg level was an independent factor associated with clinical relapse (hazard ratio, 2.251; 95% confidence interval, 1.076–4.706; P=0.031). When patients were grouped according to off-treatment HBsAg levels, clinical relapse did not occur in patients with an off-treatment HBsAg level of ≤2 log10 IU/mL (n=5), while the incidence rates of clinical relapse at 12 months after off-treatment were 28.4% and 55.7% in patients with off-treatment HBsAg levels of >2 and ≤3 log10 IU/mL (n=11) and >3 log10 IU/mL (n=28), respectively. Conclusion The off-treatment HBsAg level is closely related to clinical relapse after treatment cessation. A serum HBsAg level of <2 log10 IU/mL is an excellent predictor of a sustained off-treatment response in CHB patients who have received ETV for a sufficient duration. |
| first_indexed | 2024-12-12T14:15:01Z |
| format | Article |
| id | doaj.art-0a10b755b0824f9f8f3a94c30af44d94 |
| institution | Directory Open Access Journal |
| issn | 2287-2728 2287-285X |
| language | English |
| last_indexed | 2024-12-12T14:15:01Z |
| publishDate | 2016-09-01 |
| publisher | Korean Association for the Study of the Liver |
| record_format | Article |
| series | Clinical and Molecular Hepatology |
| spelling | doaj.art-0a10b755b0824f9f8f3a94c30af44d942022-12-22T00:21:56ZengKorean Association for the Study of the LiverClinical and Molecular Hepatology2287-27282287-285X2016-09-0122338238910.3350/cmh.2016.00471317Hepatitis B surface antigen titer is a good indicator of durable viral response after entecavir off-treatment for chronic hepatitis BHan Ah Lee0Yeon Seok Seo1Seung Woon Park2Sang Jung Park3Tae Hyung Kim4Sang Jun Suh5Young Kul Jung6Ji Hoon Kim7Hyunggin An8Hyung Joon Yim9Jong Eun Yeon10Kwan Soo Byun11Soon Ho Um12 Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea Department of Biostatistics, Korea University College of Medicine, Seoul, Korea Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea Department of Internal Medicine, Korea University College of Medicine, Seoul, KoreaBackground/Aims Clear indicators for stopping antiviral therapy in chronic hepatitis B (CHB) patients are not yet available. Since the level of hepatitis B surface antigen (HBsAg) is correlated with covalently closed circular DNA, the HBsAg titer might be a good indicator of the off-treatment response. This study aimed to determine the relationship between the HBsAg titer and the entecavir (ETV) off-treatment response. Methods This study analyzed 44 consecutive CHB patients (age, 44.6±11.4 years, mean±SD; men, 63.6%; positive hepatitis B envelope antigen (HBeAg) at baseline, 56.8%; HBV DNA level, 6.8±1.3 log10 IU/mL) treated with ETV for a sufficient duration and in whom treatment was discontinued after HBsAg levels were measured. A virological relapse was defined as an increase in serum HBV DNA level of >2000 IU/mL, and a clinical relapse was defined as a virological relapse with a biochemical flare, defined as an increase in the serum alanine aminotransferase level of >2 × upper limit of normal. Results After stopping ETV, virological relapse and clinical relapse were observed in 32 and 24 patients, respectively, during 20.8±19.9 months of follow-up. The cumulative incidence rates of virological relapse were 36.2% and 66.2%, respectively, at 6 and 12 months, and those of clinical relapse were 14.3% and 42.3%. The off-treatment HBsAg level was an independent factor associated with clinical relapse (hazard ratio, 2.251; 95% confidence interval, 1.076–4.706; P=0.031). When patients were grouped according to off-treatment HBsAg levels, clinical relapse did not occur in patients with an off-treatment HBsAg level of ≤2 log10 IU/mL (n=5), while the incidence rates of clinical relapse at 12 months after off-treatment were 28.4% and 55.7% in patients with off-treatment HBsAg levels of >2 and ≤3 log10 IU/mL (n=11) and >3 log10 IU/mL (n=28), respectively. Conclusion The off-treatment HBsAg level is closely related to clinical relapse after treatment cessation. A serum HBsAg level of <2 log10 IU/mL is an excellent predictor of a sustained off-treatment response in CHB patients who have received ETV for a sufficient duration.http://e-cmh.org/upload/pdf/cmh-2016-0047.pdfHepatitis B virusHepatitis B surface antigenRelapseOff-treatment |
| spellingShingle | Han Ah Lee Yeon Seok Seo Seung Woon Park Sang Jung Park Tae Hyung Kim Sang Jun Suh Young Kul Jung Ji Hoon Kim Hyunggin An Hyung Joon Yim Jong Eun Yeon Kwan Soo Byun Soon Ho Um Hepatitis B surface antigen titer is a good indicator of durable viral response after entecavir off-treatment for chronic hepatitis B Clinical and Molecular Hepatology Hepatitis B virus Hepatitis B surface antigen Relapse Off-treatment |
| title | Hepatitis B surface antigen titer is a good indicator of durable viral response after entecavir off-treatment for chronic hepatitis B |
| title_full | Hepatitis B surface antigen titer is a good indicator of durable viral response after entecavir off-treatment for chronic hepatitis B |
| title_fullStr | Hepatitis B surface antigen titer is a good indicator of durable viral response after entecavir off-treatment for chronic hepatitis B |
| title_full_unstemmed | Hepatitis B surface antigen titer is a good indicator of durable viral response after entecavir off-treatment for chronic hepatitis B |
| title_short | Hepatitis B surface antigen titer is a good indicator of durable viral response after entecavir off-treatment for chronic hepatitis B |
| title_sort | hepatitis b surface antigen titer is a good indicator of durable viral response after entecavir off treatment for chronic hepatitis b |
| topic | Hepatitis B virus Hepatitis B surface antigen Relapse Off-treatment |
| url | http://e-cmh.org/upload/pdf/cmh-2016-0047.pdf |
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