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Conference Paper: Low HBcrAg and HBsAg levels identify patients most likely to achieve sustained response after nucleos(t)ide analogue cessation: results from a global individual patient data meta-analysis (create study)

TitleLow HBcrAg and HBsAg levels identify patients most likely to achieve sustained response after nucleos(t)ide analogue cessation: results from a global individual patient data meta-analysis (create study)
Authors
Issue Date2020
PublisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/jhep
Citation
Digital International Liver Congress (Digital ILC 2020), 27-29 August 2020. In Journal of Hepatology, 2020, v. 73 n. Suppl. 1, p. S873-S874 How to Cite?
AbstractBackground and Aims: Sustained response is observed in a limited number of patients after cessation of nucleo(s)tide analogue (NA) therapy. We aimed to study the relationship between serum levels of hepatitis B core related antigen (HBcrAg) and HBsAg at treatment cessation and subsequent sustained virological response and HBsAg loss. Method: We performed an individual patient data meta-analysis of patients who discontinued NA therapy in compliance with EASL criteria. Patient data was acquired from 9 cohorts from Asia and Europe. HBcrAg and HBsAg were measured at treatment cessation. Studied endpoints included virological response (VR, defined as HBV DNA <2,000 IU/mL) and HBsAg loss at 24 and 48 weeks off-treatment. Retreatment was based on HBV DNA and ALT criteria, and retreated patients were considered non-responders. Results: We analysed 464 patients, of whom 317 (68%) were male and 75 (16%) were HBeAg positive at the time of treatment initiation. Median treatment duration was 294 weeks (IQR: 196–428), and median duration of consolidation therapy was 102 weeks (IQR: 56–165). Patients were treated with ETV/TDF/other in 61%/27%/12%. VR was observed in 234/464 (50%) at week 24 and 155/401 (39%) at week 48 post-treatment. HBsAg loss was observed in 17 (4%) patients. 216 patients were retreated during the follow-up period, with HBV DNA elevation (76%) and ALT flare (21%) the main indications. All resolved without sequelae after retreatment. VR at week 24 was observed in 74/113 (66%) of patients with HBcrAg <2 log at treatment cessation, compared to 44% in patients with HBcrAg >3 log (p = 0.001; figure 1). Similar results were observed at post-treatment week 48. HBsAg loss was observed in 12% of patients with HBcrAg <2 log at treatment cessation, versus 1% in patients with HBcrAg >3 log (p < 0.001). Similarly, VR at week 24 was observed in 21/26 (81%) of patients with HBsAg <10 IU/mL, versus 47% in patients with HBsAg >50 IU/mL (p = 0.001) at treatment cessation. Similar results were obtained when response was assessed at post-treatment week 48. HBsAg loss was observed in 27% of patients with HBsAg <10 IU/mL at treatment cessation, versus 2% in patients with HBsAg >50 IU/mL (p < 0.001). Findings were consistent when limited to the subset of patients who were HBeAg-negative at start of NA therapy. Conclusion: In this global individual patient data meta-analysis of patients who discontinued NA therapy, low HBcrAg (<2 log) and low HBsAg levels (<50 IU/mL) at treatment cessation were associated with highest rates of VR and HBsAg loss. These cut-offs could be used for an improved selection of patients for NA cessation.
DescriptionPoster presentation- Viral hepatitis A/E: Clinical aspects - no. SAT444
Persistent Identifierhttp://hdl.handle.net/10722/289188
ISSN
2019 Impact Factor: 20.582
2015 SCImago Journal Rankings: 4.570

 

DC FieldValueLanguage
dc.contributor.authorSonneveld, M-
dc.contributor.authorPark, JY-
dc.contributor.authorSeto, WKW-
dc.contributor.authorTanaka, Y-
dc.contributor.authorCarey, I-
dc.contributor.authorPapatheodoridi, M-
dc.contributor.authorZoulim, F-
dc.contributor.authorAhn, SH-
dc.contributor.authorDalekos, G-
dc.contributor.authorHoener zu Siederdissen, C-
dc.contributor.authorCornberg, M-
dc.contributor.authorYuen, RMF-
dc.contributor.authorAgarwal, K-
dc.contributor.authorBoonstra, A-
dc.contributor.authorButi, M-
dc.contributor.authorPapatheodoridis, G-
dc.contributor.authorMaasoumy, B-
dc.date.accessioned2020-10-22T08:09:06Z-
dc.date.available2020-10-22T08:09:06Z-
dc.date.issued2020-
dc.identifier.citationDigital International Liver Congress (Digital ILC 2020), 27-29 August 2020. In Journal of Hepatology, 2020, v. 73 n. Suppl. 1, p. S873-S874-
dc.identifier.issn0168-8278-
dc.identifier.urihttp://hdl.handle.net/10722/289188-
dc.descriptionPoster presentation- Viral hepatitis A/E: Clinical aspects - no. SAT444-
dc.description.abstractBackground and Aims: Sustained response is observed in a limited number of patients after cessation of nucleo(s)tide analogue (NA) therapy. We aimed to study the relationship between serum levels of hepatitis B core related antigen (HBcrAg) and HBsAg at treatment cessation and subsequent sustained virological response and HBsAg loss. Method: We performed an individual patient data meta-analysis of patients who discontinued NA therapy in compliance with EASL criteria. Patient data was acquired from 9 cohorts from Asia and Europe. HBcrAg and HBsAg were measured at treatment cessation. Studied endpoints included virological response (VR, defined as HBV DNA <2,000 IU/mL) and HBsAg loss at 24 and 48 weeks off-treatment. Retreatment was based on HBV DNA and ALT criteria, and retreated patients were considered non-responders. Results: We analysed 464 patients, of whom 317 (68%) were male and 75 (16%) were HBeAg positive at the time of treatment initiation. Median treatment duration was 294 weeks (IQR: 196–428), and median duration of consolidation therapy was 102 weeks (IQR: 56–165). Patients were treated with ETV/TDF/other in 61%/27%/12%. VR was observed in 234/464 (50%) at week 24 and 155/401 (39%) at week 48 post-treatment. HBsAg loss was observed in 17 (4%) patients. 216 patients were retreated during the follow-up period, with HBV DNA elevation (76%) and ALT flare (21%) the main indications. All resolved without sequelae after retreatment. VR at week 24 was observed in 74/113 (66%) of patients with HBcrAg <2 log at treatment cessation, compared to 44% in patients with HBcrAg >3 log (p = 0.001; figure 1). Similar results were observed at post-treatment week 48. HBsAg loss was observed in 12% of patients with HBcrAg <2 log at treatment cessation, versus 1% in patients with HBcrAg >3 log (p < 0.001). Similarly, VR at week 24 was observed in 21/26 (81%) of patients with HBsAg <10 IU/mL, versus 47% in patients with HBsAg >50 IU/mL (p = 0.001) at treatment cessation. Similar results were obtained when response was assessed at post-treatment week 48. HBsAg loss was observed in 27% of patients with HBsAg <10 IU/mL at treatment cessation, versus 2% in patients with HBsAg >50 IU/mL (p < 0.001). Findings were consistent when limited to the subset of patients who were HBeAg-negative at start of NA therapy. Conclusion: In this global individual patient data meta-analysis of patients who discontinued NA therapy, low HBcrAg (<2 log) and low HBsAg levels (<50 IU/mL) at treatment cessation were associated with highest rates of VR and HBsAg loss. These cut-offs could be used for an improved selection of patients for NA cessation.-
dc.languageeng-
dc.publisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/jhep-
dc.relation.ispartofJournal of Hepatology-
dc.relation.ispartofDigital International Liver Congress (Digital ILC 2020)-
dc.titleLow HBcrAg and HBsAg levels identify patients most likely to achieve sustained response after nucleos(t)ide analogue cessation: results from a global individual patient data meta-analysis (create study)-
dc.typeConference_Paper-
dc.identifier.emailSeto, WKW: wkseto@hku.hk-
dc.identifier.emailYuen, RMF: mfyuen@hku.hk-
dc.identifier.authoritySeto, WKW=rp01659-
dc.identifier.authorityYuen, RMF=rp00479-
dc.description.natureabstract-
dc.identifier.doi10.1016/S0168-8278(20)32189-9-
dc.identifier.hkuros315887-
dc.identifier.volume73-
dc.identifier.issueSuppl. 1-
dc.identifier.spageS873-
dc.identifier.epageS874-
dc.publisher.placeNetherlands-

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