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Article: Prediction Of Sustained Response After Nucleo(s)tide Analogue Cessation Using Hbsag And Hbcrag Levels – A Multicenter Study (create)

TitlePrediction Of Sustained Response After Nucleo(s)tide Analogue Cessation Using Hbsag And Hbcrag Levels – A Multicenter Study (create)
Authors
KeywordsHBcrAg
HBsAg
SCALE-B
Sustained Response
Issue Date2020
PublisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/cgh
Citation
Clinical Gastroenterology and Hepatology, 2020, Epub 2020-12-01 How to Cite?
AbstractBackground & Aims: Predictors of successful nucleo(s)tide analogue (NA) therapy withdrawal remain elusive. We studied the relationship between end-of-treatment levels of hepatitis B core-related antigen (HBcrAg) and hepatitis B surface antigen (HBsAg) and outcome after therapy cessation. Methods: Patients who discontinued NA therapy in centers in Asia and Europe were enrolled. HBcrAg and HBsAg were measured at treatment cessation, and associations with off-treatment outcomes were explored. The SCALE-B (Surface antigen, Core-related antigen, Age, ALT, and tenofovir for HBV) score was calculated as previously reported. End points included sustained virologic response (VR; hepatitis B virus DNA level <2000 IU/mL), HBsAg loss, and alanine aminotransferase (ALT) flares (>3× upper limit of normal). Re-treated patients were considered nonresponders. Results: We analyzed 572 patients, 457 (80%) were Asian and 95 (17%) were hepatitis B e antigen positive at the start of NA therapy. The median treatment duration was 295 weeks. VR was observed in 267 (47%), HBsAg loss was observed in 24 (4.2%), and ALT flare was observed in 92 (16%). VR (67% vs 42%) and HBsAg loss (15% vs 1.5%) was observed more frequently in non-Asian patients when compared to Asian patients ( P < .001). Lower HBcrAg levels were associated with higher rates of VR (odds ratio [OR], 0.701; P < .001) and HBsAg loss (OR, 0.476; P < .001), and lower rates of ALT flares (OR, 1.288; P = .005). Similar results were observed with HBsAg (VR: OR, 0.812; P = .011; HBsAg loss: OR, 0.380; P < .001; and ALT flare: OR, 1.833; P < .001). Lower SCALE-B scores were associated with higher rates of VR, HBsAg loss, and lower rates of ALT flares in both Asian and non-Asian patients ( P < .001). Conclusions: In this multicenter study, off-treatment outcomes after NA cessation varied with ethnicity. Lower levels of HBcrAg and HBsAg were associated with favorable outcomes. A risk score comprising both factors can be used for risk stratification.
DescriptionHybrid open access
Persistent Identifierhttp://hdl.handle.net/10722/295330
ISSN
2019 Impact Factor: 8.549
2015 SCImago Journal Rankings: 2.744

 

DC FieldValueLanguage
dc.contributor.authorSonneveld, MJ-
dc.contributor.authorPark, JY-
dc.contributor.authorKaewdech, A-
dc.contributor.authorSeto, WK-
dc.contributor.authorTanaka, Y-
dc.contributor.authorCarey, I-
dc.contributor.authorPapatheodoridi, M-
dc.contributor.authorvan Bommel, F-
dc.contributor.authorBerg, T-
dc.contributor.authorZoulim, F-
dc.contributor.authorAhn, SH-
dc.contributor.authorDalekos, GN-
dc.contributor.authorErler, NS-
dc.contributor.authorHoner zu Siederdissen, C-
dc.contributor.authorWedemeyer, H-
dc.contributor.authorCornberg, M-
dc.contributor.authorYuen, MF-
dc.contributor.authorAgarwal, K-
dc.contributor.authorBoonstra, A-
dc.contributor.authorButi, M-
dc.contributor.authorPiratvisuth, T-
dc.contributor.authorPapatheodoridis, G-
dc.contributor.authorMaasoumy, B-
dc.date.accessioned2021-01-11T13:58:35Z-
dc.date.available2021-01-11T13:58:35Z-
dc.date.issued2020-
dc.identifier.citationClinical Gastroenterology and Hepatology, 2020, Epub 2020-12-01-
dc.identifier.issn1542-3565-
dc.identifier.urihttp://hdl.handle.net/10722/295330-
dc.descriptionHybrid open access-
dc.description.abstractBackground & Aims: Predictors of successful nucleo(s)tide analogue (NA) therapy withdrawal remain elusive. We studied the relationship between end-of-treatment levels of hepatitis B core-related antigen (HBcrAg) and hepatitis B surface antigen (HBsAg) and outcome after therapy cessation. Methods: Patients who discontinued NA therapy in centers in Asia and Europe were enrolled. HBcrAg and HBsAg were measured at treatment cessation, and associations with off-treatment outcomes were explored. The SCALE-B (Surface antigen, Core-related antigen, Age, ALT, and tenofovir for HBV) score was calculated as previously reported. End points included sustained virologic response (VR; hepatitis B virus DNA level <2000 IU/mL), HBsAg loss, and alanine aminotransferase (ALT) flares (>3× upper limit of normal). Re-treated patients were considered nonresponders. Results: We analyzed 572 patients, 457 (80%) were Asian and 95 (17%) were hepatitis B e antigen positive at the start of NA therapy. The median treatment duration was 295 weeks. VR was observed in 267 (47%), HBsAg loss was observed in 24 (4.2%), and ALT flare was observed in 92 (16%). VR (67% vs 42%) and HBsAg loss (15% vs 1.5%) was observed more frequently in non-Asian patients when compared to Asian patients ( P < .001). Lower HBcrAg levels were associated with higher rates of VR (odds ratio [OR], 0.701; P < .001) and HBsAg loss (OR, 0.476; P < .001), and lower rates of ALT flares (OR, 1.288; P = .005). Similar results were observed with HBsAg (VR: OR, 0.812; P = .011; HBsAg loss: OR, 0.380; P < .001; and ALT flare: OR, 1.833; P < .001). Lower SCALE-B scores were associated with higher rates of VR, HBsAg loss, and lower rates of ALT flares in both Asian and non-Asian patients ( P < .001). Conclusions: In this multicenter study, off-treatment outcomes after NA cessation varied with ethnicity. Lower levels of HBcrAg and HBsAg were associated with favorable outcomes. A risk score comprising both factors can be used for risk stratification.-
dc.languageeng-
dc.publisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/cgh-
dc.relation.ispartofClinical Gastroenterology and Hepatology-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectHBcrAg-
dc.subjectHBsAg-
dc.subjectSCALE-B-
dc.subjectSustained Response-
dc.titlePrediction Of Sustained Response After Nucleo(s)tide Analogue Cessation Using Hbsag And Hbcrag Levels – A Multicenter Study (create)-
dc.typeArticle-
dc.identifier.emailSeto, WK: wkseto@hku.hk-
dc.identifier.emailYuen, MF: mfyuen@hku.hk-
dc.identifier.authoritySeto, WK=rp01659-
dc.identifier.authorityYuen, MF=rp00479-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1016/j.cgh.2020.12.005-
dc.identifier.pmid33309804-
dc.identifier.scopuseid_2-s2.0-85104274872-
dc.identifier.hkuros320859-
dc.identifier.volumeEpub 2020-12-01-
dc.publisher.placeUnited States-

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