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Clearance of hepatitis B surface antigen during long-term nucleot(s)ide analog treatment in chronic hepatitis B: results from a nine-year longitudinal study.
- Source :
-
Journal of gastroenterology [J Gastroenterol] 2013 Aug; Vol. 48 (8), pp. 930-41. Date of Electronic Publication: 2012 Oct 12. - Publication Year :
- 2013
-
Abstract
- Background: Clearance of hepatitis B surface antigen (HBsAg) is considered the ultimate goal in chronic hepatitis B treatment. One treatment option is long-term nucleot(s)ide analog (NA) therapy. We followed a group of long-term NA therapy patients to evaluate the efficacy of this treatment in promoting clearance and longitudinal declines of HBsAg.<br />Method: The study included 791 NA therapy patients who received lamivudine as their first drug. At the baseline, 442 patients were hepatitis B e antigen (HBeAg)+ and 349 were HBeAg-. All analyses were performed after separating the HBeAg+ and HBeAg- cohorts. Cox proportional hazards models were used to determine which factors were associated with HBsAg clearance.<br />Results: HBsAg clearance was observed in 18 (4.1 %) of the HBeAg+ patients and 20 (5.7 %) of the HBeAg- patients at baseline, giving seroclearance rates of 6.4 and 6.9 %, respectively, over the nine-year study period. HBsAg clearance was influenced by several independent factors that varied according to HBeAg cohort. For HBeAg+ patients, these included previous interferon therapy, infection with hepatitis B virus (HBV) genotype A, a ≥0.5 log IU/mL decline in HBsAg level within six months, and clearance of HBeAg at six months. For HBeAg- patients, these included infection with HBV genotype A, decline in HBsAg at six months, and a baseline HBsAg level of <730 IU/mL.<br />Conclusion: This study suggests that both direct antiviral potential and host immune response are needed to achieve HBsAg clearance by NA therapy. Viral genotype strongly influenced HBsAg clearance during NA therapy.
- Subjects :
- Adult
Antiviral Agents administration & dosage
Female
Follow-Up Studies
Genotype
Hepatitis B e Antigens blood
Hepatitis B virus genetics
Hepatitis B, Chronic virology
Humans
Lamivudine administration & dosage
Lamivudine therapeutic use
Longitudinal Studies
Male
Middle Aged
Nucleosides administration & dosage
Nucleosides therapeutic use
Nucleotides administration & dosage
Nucleotides therapeutic use
Proportional Hazards Models
Retrospective Studies
Treatment Outcome
Antiviral Agents therapeutic use
Hepatitis B Surface Antigens blood
Hepatitis B virus isolation & purification
Hepatitis B, Chronic drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1435-5922
- Volume :
- 48
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 23065021
- Full Text :
- https://doi.org/10.1007/s00535-012-0688-7