| Nucleos(t)ide analogues only induce temporary hepatitis B e antigen seroconversion in most patients with chronic hepatitis B. | |
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MedLine Citation:
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PMID: 20381492 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND & AIMS: Inconsistencies in results and guideline recommendations regarding the durability of nucleos(t)ide analogue-induced hepatitis B e antigen (HBeAg) seroconversion require clarification. We studied the long-term durability of nucleos(t)ide analogue-induced HBeAg seroconversion in patients with chronic hepatitis B virus (HBV) infection. METHODS: We performed a single-center cohort study of 132 HBeAg-positive patients who had received nucleos(t)ide analogue therapy. RESULTS: During a median treatment duration of 26 months (range, 16-43 mo), HBeAg seroconversion occurred in 46 of 132 subjects (35%). Forty-two subjects (91%) had follow-up evaluation after HBeAg seroconversion. During a median follow-up period of 59 months (range, 28-103 mo) after HBeAg seroconversion, 13 of 42 patients (31%) showed a durable remission (defined as HBeAg negative and HBV-DNA level<10,000 copies/mL). Overall, 33 of 42 subjects (79%) continued therapy after HBeAg seroconversion; of these, 22 (67%) showed serologic and/or virologic recurrence. Nine of 42 subjects (21%) discontinued therapy after HBeAg seroconversion and at least 6 months of consolidation therapy. Only 2 patients showed a durable response in the absence of therapy. Disease recurrence in patients who continued therapy after HBeAg seroconversion was preceded by the development of resistance (80% of these patients); resistance only occurred in subjects given lamivudine monotherapy. In contrast, recurrence after treatment discontinuation or noncompliance was observed in all patients given nucleos(t)ide analogues. CONCLUSIONS: Induction of HBeAg seroconversion by nucleos(t)ide analogues is temporary in most patients with chronic HBV infection. Long-term continuation of nucleos(t)ide analogue treatment, irrespective of the occurrence of HBeAg seroconversion, appears to be necessary. |
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Authors:
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Jurriën G P Reijnders; Moniek J Perquin; Ningping Zhang; Bettina E Hansen; Harry L A Janssen |
Publication Detail:
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Type: Journal Article Date: 2010-04-08 |
Journal Detail:
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Title: Gastroenterology Volume: 139 ISSN: 1528-0012 ISO Abbreviation: Gastroenterology Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-27 Completed Date: 2010-08-12 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0374630 Medline TA: Gastroenterology Country: United States |
Other Details:
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Languages: eng Pagination: 491-8 Citation Subset: AIM; IM |
Copyright Information:
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Copyright (c) 2010 AGA Institute. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Antiviral Agents / administration & dosage* Biological Markers / blood Cohort Studies DNA, Viral / blood Drug Administration Schedule Drug Resistance, Viral Endpoint Determination Female Hepatitis B e Antigens / blood* Hepatitis B virus / genetics, immunology* Hepatitis B, Chronic / diagnosis, drug therapy* Humans Kaplan-Meiers Estimate Male Medication Adherence Middle Aged Nucleosides / administration & dosage* Nucleotides / administration & dosage* Proportional Hazards Models Recurrence Risk Assessment Time Factors Treatment Outcome Viral Load Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Antiviral Agents; 0/Biological Markers; 0/DNA, Viral; 0/Hepatitis B e Antigens; 0/Nucleosides; 0/Nucleotides |
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