Document Detail


Nucleos(t)ide analogues only induce temporary hepatitis B e antigen seroconversion in most patients with chronic hepatitis B.
MedLine Citation:
PMID:  20381492     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Jurriën G P Reijnders; Moniek J Perquin; Ningping Zhang; Bettina E Hansen; Harry L A Janssen
Publication Detail:
Type:  Journal Article     Date:  2010-04-08
Journal Detail:
Title:  Gastroenterology     Volume:  139     ISSN:  1528-0012     ISO Abbreviation:  Gastroenterology     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-27     Completed Date:  2010-08-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  491-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright (c) 2010 AGA Institute. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
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:
0/Antiviral Agents; 0/Biological Markers; 0/DNA, Viral; 0/Hepatitis B e Antigens; 0/Nucleosides; 0/Nucleotides

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