Clinical Utility of SCALE-B to Predict Hepatitis B Virus Relapse, Hepatitis B Surface Antigen Loss After Antiviral Cessation in Asian Patients After 2-Year Follow-up
BackgroundDiscontinuation of antiviral therapy in chronic hepatitis B (CHB) patients leads to a higher hepatitis B surface antigen (HBsAg) loss; yet, clinical relapse (CR) may occur. SCALE-B score was developed to predict off-treatment CR; however, validation of SCALE-B beyond a 48-week follow-up is...
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Frontiers Media S.A.
2022-03-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.859430/full |
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| author | Apichat Kaewdech Suraphon Assawasuwannakit Suraphon Assawasuwannakit Pimsiri Sripongpun Naichaya Chamroonkul Pisit Tangkijvanich Pisit Tangkijvanich Teerha Piratvisuth Teerha Piratvisuth |
| author_facet | Apichat Kaewdech Suraphon Assawasuwannakit Suraphon Assawasuwannakit Pimsiri Sripongpun Naichaya Chamroonkul Pisit Tangkijvanich Pisit Tangkijvanich Teerha Piratvisuth Teerha Piratvisuth |
| author_sort | Apichat Kaewdech |
| collection | DOAJ |
| description | BackgroundDiscontinuation of antiviral therapy in chronic hepatitis B (CHB) patients leads to a higher hepatitis B surface antigen (HBsAg) loss; yet, clinical relapse (CR) may occur. SCALE-B score was developed to predict off-treatment CR; however, validation of SCALE-B beyond a 48-week follow-up is rare. We studied whether SCALE-B and hepatitis B virus ribonucleic acid (HBV RNA) could predict outcomes in CHB patients after a 2-year follow-up.MethodsA total of 92 Thai CHB patients who stopped antiviral treatment were followed up; baseline characteristics, quantitative hepatitis B surface antigen (qHBsAg), hepatitis B core-related antigen (HBcrAg), and HBV RNA were collected at the time of discontinuation, and SCALE-B scores were calculated. Patients were followed up every 12 weeks for 48 weeks, and then, the intervals were upon primary doctors. Follow-up data regarding virological relapse (VR), CR, and HBsAg loss were obtained.ResultsThe median follow-up duration was 142 weeks; the cumulative incidences of VR, CR, and HBsAg loss were 65.2, 33.7, and 7.6%, respectively. After 48 weeks, VR and CR plateaued, but HBsAg loss increased from 2.2 to 7.6%. According to the SCALE-B strata, VR, CR, and HBsAg loss were significantly different. The highest stratum (≥ 320) was associated with higher VR, CR, and lesser HBsAg loss when compared to the lowest stratum, with adjusted hazard ratios of 5.0 (95% CIs: 1.8–14.4), 10.44 (95% CIs: 1.4–79.1), and 0.04 (95% CIs: 0.004–0.43), respectively.ConclusionAt a median follow-up of 2.5 years after discontinuing therapy, HBsAg loss in Thai patients was found to increase over time. SCALE-B is a valuable tool for predicting CR, VR, and HBsAg loss; HBV RNA is not significantly associated with long-term outcomes.Clinical Trial Registration[www.ClinicalTrials.gov], identifier [TCTR20180316007]. |
| first_indexed | 2024-12-13T08:18:24Z |
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| language | English |
| last_indexed | 2024-12-13T08:18:24Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
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| spelling | doaj.art-189b51f77c784cc18a37415dacdfa7912022-12-21T23:54:03ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-03-01910.3389/fmed.2022.859430859430Clinical Utility of SCALE-B to Predict Hepatitis B Virus Relapse, Hepatitis B Surface Antigen Loss After Antiviral Cessation in Asian Patients After 2-Year Follow-upApichat Kaewdech0Suraphon Assawasuwannakit1Suraphon Assawasuwannakit2Pimsiri Sripongpun3Naichaya Chamroonkul4Pisit Tangkijvanich5Pisit Tangkijvanich6Teerha Piratvisuth7Teerha Piratvisuth8Gastroenterology and Hepatology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, ThailandGastroenterology and Hepatology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, ThailandDepartment of Medicine, Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University, Nonthaburi, ThailandGastroenterology and Hepatology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, ThailandGastroenterology and Hepatology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, ThailandDepartment of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandCenter of Excellence in Hepatitis and Liver Cancer, Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandGastroenterology and Hepatology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, ThailandNKC Institute of Gastroenterology and Hepatology, Songklanagarind Hospital, Prince of Songkla University, Hat Yai, ThailandBackgroundDiscontinuation of antiviral therapy in chronic hepatitis B (CHB) patients leads to a higher hepatitis B surface antigen (HBsAg) loss; yet, clinical relapse (CR) may occur. SCALE-B score was developed to predict off-treatment CR; however, validation of SCALE-B beyond a 48-week follow-up is rare. We studied whether SCALE-B and hepatitis B virus ribonucleic acid (HBV RNA) could predict outcomes in CHB patients after a 2-year follow-up.MethodsA total of 92 Thai CHB patients who stopped antiviral treatment were followed up; baseline characteristics, quantitative hepatitis B surface antigen (qHBsAg), hepatitis B core-related antigen (HBcrAg), and HBV RNA were collected at the time of discontinuation, and SCALE-B scores were calculated. Patients were followed up every 12 weeks for 48 weeks, and then, the intervals were upon primary doctors. Follow-up data regarding virological relapse (VR), CR, and HBsAg loss were obtained.ResultsThe median follow-up duration was 142 weeks; the cumulative incidences of VR, CR, and HBsAg loss were 65.2, 33.7, and 7.6%, respectively. After 48 weeks, VR and CR plateaued, but HBsAg loss increased from 2.2 to 7.6%. According to the SCALE-B strata, VR, CR, and HBsAg loss were significantly different. The highest stratum (≥ 320) was associated with higher VR, CR, and lesser HBsAg loss when compared to the lowest stratum, with adjusted hazard ratios of 5.0 (95% CIs: 1.8–14.4), 10.44 (95% CIs: 1.4–79.1), and 0.04 (95% CIs: 0.004–0.43), respectively.ConclusionAt a median follow-up of 2.5 years after discontinuing therapy, HBsAg loss in Thai patients was found to increase over time. SCALE-B is a valuable tool for predicting CR, VR, and HBsAg loss; HBV RNA is not significantly associated with long-term outcomes.Clinical Trial Registration[www.ClinicalTrials.gov], identifier [TCTR20180316007].https://www.frontiersin.org/articles/10.3389/fmed.2022.859430/fullclinical relapse (CR)hepatitis B core-related antigen (HBcrAg)hepatitis B surface antigen (HBsAg)hepatitis B virus ribonucleic acid (HBV RNA)nucleos(t)ide analogues (NAs)cessation |
| spellingShingle | Apichat Kaewdech Suraphon Assawasuwannakit Suraphon Assawasuwannakit Pimsiri Sripongpun Naichaya Chamroonkul Pisit Tangkijvanich Pisit Tangkijvanich Teerha Piratvisuth Teerha Piratvisuth Clinical Utility of SCALE-B to Predict Hepatitis B Virus Relapse, Hepatitis B Surface Antigen Loss After Antiviral Cessation in Asian Patients After 2-Year Follow-up Frontiers in Medicine clinical relapse (CR) hepatitis B core-related antigen (HBcrAg) hepatitis B surface antigen (HBsAg) hepatitis B virus ribonucleic acid (HBV RNA) nucleos(t)ide analogues (NAs) cessation |
| title | Clinical Utility of SCALE-B to Predict Hepatitis B Virus Relapse, Hepatitis B Surface Antigen Loss After Antiviral Cessation in Asian Patients After 2-Year Follow-up |
| title_full | Clinical Utility of SCALE-B to Predict Hepatitis B Virus Relapse, Hepatitis B Surface Antigen Loss After Antiviral Cessation in Asian Patients After 2-Year Follow-up |
| title_fullStr | Clinical Utility of SCALE-B to Predict Hepatitis B Virus Relapse, Hepatitis B Surface Antigen Loss After Antiviral Cessation in Asian Patients After 2-Year Follow-up |
| title_full_unstemmed | Clinical Utility of SCALE-B to Predict Hepatitis B Virus Relapse, Hepatitis B Surface Antigen Loss After Antiviral Cessation in Asian Patients After 2-Year Follow-up |
| title_short | Clinical Utility of SCALE-B to Predict Hepatitis B Virus Relapse, Hepatitis B Surface Antigen Loss After Antiviral Cessation in Asian Patients After 2-Year Follow-up |
| title_sort | clinical utility of scale b to predict hepatitis b virus relapse hepatitis b surface antigen loss after antiviral cessation in asian patients after 2 year follow up |
| topic | clinical relapse (CR) hepatitis B core-related antigen (HBcrAg) hepatitis B surface antigen (HBsAg) hepatitis B virus ribonucleic acid (HBV RNA) nucleos(t)ide analogues (NAs) cessation |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.859430/full |
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