Off-treatment efficacy of 3-year nucleos(t)ide analogues in chronic hepatitis B patients
Lamivudine, telbivudine, and entecavir are the first-line drugs covered by the Taiwan National Health Insurance as 3-year treatments for patients with chronic hepatitis B virus (HBV), but the optimal treatment duration of each remains unclear. We aimed to detect HBV treatment-cessation durability, a...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Kaohsiung Journal of Medical Sciences |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1607551X15002582 |
| _version_ | 1818192202638032896 |
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| author | Ching-Chung Lin Ming-Jong Bair Chih-Jen Chen Keng-Han Lee Ming-Jen Chen Chia-Yuan Liu Chen-Wang Chang Kuang-Chun Hu Tai-Cherng Liou Shee-Chan Lin Horng-Yuan Wang Cheng-Hsin Chu Shou-Chuan Shih Tsang-En Wang |
| author_facet | Ching-Chung Lin Ming-Jong Bair Chih-Jen Chen Keng-Han Lee Ming-Jen Chen Chia-Yuan Liu Chen-Wang Chang Kuang-Chun Hu Tai-Cherng Liou Shee-Chan Lin Horng-Yuan Wang Cheng-Hsin Chu Shou-Chuan Shih Tsang-En Wang |
| author_sort | Ching-Chung Lin |
| collection | DOAJ |
| description | Lamivudine, telbivudine, and entecavir are the first-line drugs covered by the Taiwan National Health Insurance as 3-year treatments for patients with chronic hepatitis B virus (HBV), but the optimal treatment duration of each remains unclear. We aimed to detect HBV treatment-cessation durability, and compare the predictors in patients with and without clinical relapse. In this retrospective cohort study, 210 patients with chronic HBV who tested hepatitis B e-antigen positive or hepatitis B e-antigen negative were treated for 3 years with a nucleos(t)ide analogue. Of these, 102 patients continued therapy after 3 years, while 88 patients stopped treatment and were followed for 1 year due to financial difficulties. Efficacy was assessed in terms of alanine aminotransferase (ALT) level normalization, HBV DNA clearance, virus breakthrough, clinical relapse, and liver decompensation. The durability predictors were evaluated by host factors, HBV DNA, and drug differences. Eighty patients (14 on lamivudine, 19 on telbivudine, and 47 on entecavir) were recruited. There was no difference in clinical-relapse rate among lamivudine, telbivudine, and entecavir (35.7% vs. 36.8% vs. 31.9%, respectively; p = 0.916), and liver decompensated hepatitis was absent. In baseline clinical characteristics, there were no differences between the clinical-relapse and nonrelapse groups in age, sex, cirrhosis, prior treatment, HBV DNA, pretreatment ALT, or hepatitis B e-antigen (HBeAg). The mean 3rd year serum ALT level differed significantly between clinical-relapse and nonrelapse patients (37.5 U/L vs. 27.7 U/L, respectively; p = 0.044). The 3-year nucleos(t)ide analogue off-treatment in patients with chronic HBV delivered according to the Taiwan National Health Insurance guidelines had an overall 33.8% 1-year clinical-relapse rate without any decompensated hepatitis flare-ups. |
| first_indexed | 2024-12-12T00:26:45Z |
| format | Article |
| id | doaj.art-cf4bf80647bd4525a5b56c766ec1e69d |
| institution | Directory Open Access Journal |
| issn | 1607-551X |
| language | English |
| last_indexed | 2024-12-12T00:26:45Z |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Kaohsiung Journal of Medical Sciences |
| spelling | doaj.art-cf4bf80647bd4525a5b56c766ec1e69d2022-12-22T00:44:37ZengWileyKaohsiung Journal of Medical Sciences1607-551X2016-01-01321101510.1016/j.kjms.2015.11.005Off-treatment efficacy of 3-year nucleos(t)ide analogues in chronic hepatitis B patientsChing-Chung Lin0Ming-Jong Bair1Chih-Jen Chen2Keng-Han Lee3Ming-Jen Chen4Chia-Yuan Liu5Chen-Wang Chang6Kuang-Chun Hu7Tai-Cherng Liou8Shee-Chan Lin9Horng-Yuan Wang10Cheng-Hsin Chu11Shou-Chuan Shih12Tsang-En Wang13Division of Gastroenterology, Department of Internal Medicine and Liver Medical Center, Mackay Memorial Hospital, Taipei, TaiwanDivision of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taitung Branch, Taitung, TaiwanDivision of Gastroenterology, Department of Internal Medicine and Liver Medical Center, Mackay Memorial Hospital, Taipei, TaiwanMackay Medical College, New Taipei City, TaiwanDivision of Gastroenterology, Department of Internal Medicine and Liver Medical Center, Mackay Memorial Hospital, Taipei, TaiwanDivision of Gastroenterology, Department of Internal Medicine and Liver Medical Center, Mackay Memorial Hospital, Taipei, TaiwanDivision of Gastroenterology, Department of Internal Medicine and Liver Medical Center, Mackay Memorial Hospital, Taipei, TaiwanDivision of Gastroenterology, Department of Internal Medicine and Liver Medical Center, Mackay Memorial Hospital, Taipei, TaiwanDivision of Gastroenterology, Department of Internal Medicine and Liver Medical Center, Mackay Memorial Hospital, Taipei, TaiwanDivision of Gastroenterology, Department of Internal Medicine and Liver Medical Center, Mackay Memorial Hospital, Taipei, TaiwanDivision of Gastroenterology, Department of Internal Medicine and Liver Medical Center, Mackay Memorial Hospital, Taipei, TaiwanDivision of Gastroenterology, Department of Internal Medicine and Liver Medical Center, Mackay Memorial Hospital, Taipei, TaiwanDivision of Gastroenterology, Department of Internal Medicine and Liver Medical Center, Mackay Memorial Hospital, Taipei, TaiwanDivision of Gastroenterology, Department of Internal Medicine and Liver Medical Center, Mackay Memorial Hospital, Taipei, TaiwanLamivudine, telbivudine, and entecavir are the first-line drugs covered by the Taiwan National Health Insurance as 3-year treatments for patients with chronic hepatitis B virus (HBV), but the optimal treatment duration of each remains unclear. We aimed to detect HBV treatment-cessation durability, and compare the predictors in patients with and without clinical relapse. In this retrospective cohort study, 210 patients with chronic HBV who tested hepatitis B e-antigen positive or hepatitis B e-antigen negative were treated for 3 years with a nucleos(t)ide analogue. Of these, 102 patients continued therapy after 3 years, while 88 patients stopped treatment and were followed for 1 year due to financial difficulties. Efficacy was assessed in terms of alanine aminotransferase (ALT) level normalization, HBV DNA clearance, virus breakthrough, clinical relapse, and liver decompensation. The durability predictors were evaluated by host factors, HBV DNA, and drug differences. Eighty patients (14 on lamivudine, 19 on telbivudine, and 47 on entecavir) were recruited. There was no difference in clinical-relapse rate among lamivudine, telbivudine, and entecavir (35.7% vs. 36.8% vs. 31.9%, respectively; p = 0.916), and liver decompensated hepatitis was absent. In baseline clinical characteristics, there were no differences between the clinical-relapse and nonrelapse groups in age, sex, cirrhosis, prior treatment, HBV DNA, pretreatment ALT, or hepatitis B e-antigen (HBeAg). The mean 3rd year serum ALT level differed significantly between clinical-relapse and nonrelapse patients (37.5 U/L vs. 27.7 U/L, respectively; p = 0.044). The 3-year nucleos(t)ide analogue off-treatment in patients with chronic HBV delivered according to the Taiwan National Health Insurance guidelines had an overall 33.8% 1-year clinical-relapse rate without any decompensated hepatitis flare-ups.http://www.sciencedirect.com/science/article/pii/S1607551X15002582Alanine aminotransferaseEntecavirHepatitis B virusLamivudineTelbivudine |
| spellingShingle | Ching-Chung Lin Ming-Jong Bair Chih-Jen Chen Keng-Han Lee Ming-Jen Chen Chia-Yuan Liu Chen-Wang Chang Kuang-Chun Hu Tai-Cherng Liou Shee-Chan Lin Horng-Yuan Wang Cheng-Hsin Chu Shou-Chuan Shih Tsang-En Wang Off-treatment efficacy of 3-year nucleos(t)ide analogues in chronic hepatitis B patients Kaohsiung Journal of Medical Sciences Alanine aminotransferase Entecavir Hepatitis B virus Lamivudine Telbivudine |
| title | Off-treatment efficacy of 3-year nucleos(t)ide analogues in chronic hepatitis B patients |
| title_full | Off-treatment efficacy of 3-year nucleos(t)ide analogues in chronic hepatitis B patients |
| title_fullStr | Off-treatment efficacy of 3-year nucleos(t)ide analogues in chronic hepatitis B patients |
| title_full_unstemmed | Off-treatment efficacy of 3-year nucleos(t)ide analogues in chronic hepatitis B patients |
| title_short | Off-treatment efficacy of 3-year nucleos(t)ide analogues in chronic hepatitis B patients |
| title_sort | off treatment efficacy of 3 year nucleos t ide analogues in chronic hepatitis b patients |
| topic | Alanine aminotransferase Entecavir Hepatitis B virus Lamivudine Telbivudine |
| url | http://www.sciencedirect.com/science/article/pii/S1607551X15002582 |
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