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Conference Paper: Treatment Cessation in Chronic Hepatitis B: Predicting Off-Treatment Durability Via Combination of Viral Markers
Title | Treatment Cessation in Chronic Hepatitis B: Predicting Off-Treatment Durability Via Combination of Viral Markers |
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Authors | |
Issue Date | 2018 |
Publisher | John Wiley & Sons, Inc. The Journal's web site is located at http://www.hepatology.org/ |
Citation | The Liver Meeting 2018, American Association for the Study of Liver Diseases (AASLD), San Francisco, USA, 9-13 November 2018. Abstracts in Hepatology, 2018, v. 68 n. Suppl. 1, p. 248A-249A How to Cite? |
Abstract | Background: Treatment cessation in nucleoside analoguetreated chronic hepatitis B (CHB) can be associated with high rates of disease relapse. Serum hepatitis B surface antigen (HBsAg) levels have been suggested as a marker reflecting immune control. We investigated the efficacy of treatment
cessation and predictors of successful off-treatment durability in CHB patients with low serum HBsAg levels. Methods: We prospectively recruited consecutive non-cirrhotic HBsAgpositive patients treated with entecavir or tenofovir with serum HBsAg <200 IU/mL and fulfilling the European Association for
the Study of the Liver (EASL) criteria for treatment cessation. Liver biochemistry, serum HBV DNA, HBsAg and hepatitis B core-related antigen (HBcrAg) were measured at baseline and every 6 weeks up to week 48 after treatment cessation. HBV reactivation was defined as HBV DNA >2,000 IU/mL.
Treatment was re-initiated in patients with HBV reactivation and elevated alanine aminotransferase (ALT) (>40 U/L), or with two consecutive HBV DNA readings of >2,000 IU/mL (the second measurement taken within two weeks). Results: In this interim analysis, 103 patients (mean age 56.4 ±10.9 years, 67.0% male) with a mean nucleoside analogue treatment duration of 7.1 (±2.0) years were recruited. Median duration of follow-up after treatment cessation was 42 (IQR 29-48) weeks. Median baseline HBsAg and HBcrAg levels were 55.3 (16.9-89.5) IU/mL and 1.1 (0.3-4.7) kU/mL respectively. The cumulative rate of HBV reactivation at 48 weeks, calculated by the Kaplan-Meier method, was 59.2%. Among 78 patients with available viral measurements, baseline serum HBsAg ≤10 IUmL, compared to HBsAg >10 IU/mL, had a significantly lower cumulative rate of HBV reactivation (31.6% versus 66.1%, p=0.023). A lower baseline serum HBsAg level, via Cox regression, was associated with significantly lower rates of HBV reactivation (p=0.047, OR 1.005, 95%CI 1.001-1.010). A lower baseline serum HBcrAg level was associated with lower HBV reactivation rates in patients with baseline serum HBsAg >20 IU/mL (p=0.020, OR 1.034, 95%CI 1.005-1.063) but not among all patients (p=0.147). 16 (33.3%) patients with HBV reactivation developed ALT elevation (median ALT 104 U/L, IQR 62-151 U/L). All HBV reactivation cases were eventually controlled with either entecavir or tenofovir. Conclusion: HBV reactivation remained common after treatment cessation in HBsAg-positive patients with low HBsAg levels. Combining serum HBsAg and HBcrAg kinetics can identify patients with likely off-treatment durability after treatment discontinuation. (Clinicaltrials.gov identifier NCT02738554) |
Description | Poster Presentation - no. 417 |
Persistent Identifier | http://hdl.handle.net/10722/269507 |
ISSN | 2023 Impact Factor: 12.9 2023 SCImago Journal Rankings: 5.011 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Seto, WKW | - |
dc.contributor.author | Liu, SHK | - |
dc.contributor.author | Mak, LY | - |
dc.contributor.author | Cheung, KSM | - |
dc.contributor.author | Wong, DKH | - |
dc.contributor.author | Liu, F | - |
dc.contributor.author | Fung, JYY | - |
dc.contributor.author | Lai, CL | - |
dc.contributor.author | Yuen, RMF | - |
dc.date.accessioned | 2019-04-24T08:09:05Z | - |
dc.date.available | 2019-04-24T08:09:05Z | - |
dc.date.issued | 2018 | - |
dc.identifier.citation | The Liver Meeting 2018, American Association for the Study of Liver Diseases (AASLD), San Francisco, USA, 9-13 November 2018. Abstracts in Hepatology, 2018, v. 68 n. Suppl. 1, p. 248A-249A | - |
dc.identifier.issn | 0270-9139 | - |
dc.identifier.uri | http://hdl.handle.net/10722/269507 | - |
dc.description | Poster Presentation - no. 417 | - |
dc.description.abstract | Background: Treatment cessation in nucleoside analoguetreated chronic hepatitis B (CHB) can be associated with high rates of disease relapse. Serum hepatitis B surface antigen (HBsAg) levels have been suggested as a marker reflecting immune control. We investigated the efficacy of treatment cessation and predictors of successful off-treatment durability in CHB patients with low serum HBsAg levels. Methods: We prospectively recruited consecutive non-cirrhotic HBsAgpositive patients treated with entecavir or tenofovir with serum HBsAg <200 IU/mL and fulfilling the European Association for the Study of the Liver (EASL) criteria for treatment cessation. Liver biochemistry, serum HBV DNA, HBsAg and hepatitis B core-related antigen (HBcrAg) were measured at baseline and every 6 weeks up to week 48 after treatment cessation. HBV reactivation was defined as HBV DNA >2,000 IU/mL. Treatment was re-initiated in patients with HBV reactivation and elevated alanine aminotransferase (ALT) (>40 U/L), or with two consecutive HBV DNA readings of >2,000 IU/mL (the second measurement taken within two weeks). Results: In this interim analysis, 103 patients (mean age 56.4 ±10.9 years, 67.0% male) with a mean nucleoside analogue treatment duration of 7.1 (±2.0) years were recruited. Median duration of follow-up after treatment cessation was 42 (IQR 29-48) weeks. Median baseline HBsAg and HBcrAg levels were 55.3 (16.9-89.5) IU/mL and 1.1 (0.3-4.7) kU/mL respectively. The cumulative rate of HBV reactivation at 48 weeks, calculated by the Kaplan-Meier method, was 59.2%. Among 78 patients with available viral measurements, baseline serum HBsAg ≤10 IUmL, compared to HBsAg >10 IU/mL, had a significantly lower cumulative rate of HBV reactivation (31.6% versus 66.1%, p=0.023). A lower baseline serum HBsAg level, via Cox regression, was associated with significantly lower rates of HBV reactivation (p=0.047, OR 1.005, 95%CI 1.001-1.010). A lower baseline serum HBcrAg level was associated with lower HBV reactivation rates in patients with baseline serum HBsAg >20 IU/mL (p=0.020, OR 1.034, 95%CI 1.005-1.063) but not among all patients (p=0.147). 16 (33.3%) patients with HBV reactivation developed ALT elevation (median ALT 104 U/L, IQR 62-151 U/L). All HBV reactivation cases were eventually controlled with either entecavir or tenofovir. Conclusion: HBV reactivation remained common after treatment cessation in HBsAg-positive patients with low HBsAg levels. Combining serum HBsAg and HBcrAg kinetics can identify patients with likely off-treatment durability after treatment discontinuation. (Clinicaltrials.gov identifier NCT02738554) | - |
dc.language | eng | - |
dc.publisher | John Wiley & Sons, Inc. The Journal's web site is located at http://www.hepatology.org/ | - |
dc.relation.ispartof | Hepatology | - |
dc.relation.ispartof | American Association for the Study of Liver Diseases (AASLD): The Liver Meeting 2018 | - |
dc.title | Treatment Cessation in Chronic Hepatitis B: Predicting Off-Treatment Durability Via Combination of Viral Markers | - |
dc.type | Conference_Paper | - |
dc.identifier.email | Seto, WKW: wkseto@hku.hk | - |
dc.identifier.email | Liu, SHK: drkliu@hku.hk | - |
dc.identifier.email | Cheung, KSM: cks634@hku.hk | - |
dc.identifier.email | Wong, DKH: danywong@hku.hk | - |
dc.identifier.email | Fung, JYY: jfung@hkucc.hku.hk | - |
dc.identifier.email | Lai, CL: hrmelcl@hkucc.hku.hk | - |
dc.identifier.email | Yuen, RMF: mfyuen@hku.hk | - |
dc.identifier.authority | Seto, WKW=rp01659 | - |
dc.identifier.authority | Cheung, KSM=rp02532 | - |
dc.identifier.authority | Wong, DKH=rp00492 | - |
dc.identifier.authority | Fung, JYY=rp00518 | - |
dc.identifier.authority | Lai, CL=rp00314 | - |
dc.identifier.authority | Yuen, RMF=rp00479 | - |
dc.identifier.hkuros | 297383 | - |
dc.identifier.volume | 68 | - |
dc.identifier.issue | Suppl. 1 | - |
dc.identifier.spage | 248A | - |
dc.identifier.epage | 249A | - |
dc.identifier.isi | WOS:000446020500420 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 0270-9139 | - |