Hepatitis B surface antigen titer is a good indicator of durable viral response after entecavir off-treatment for chronic hepatitis B
Background/Aims: Clear indicators for stopping antiviral therapy in chronic hepatitis B (CHB) patients are not yet available. Since the level of hepatitis B surface antigen (HBsAg) is correlated with covalently closed circular DNA, the HBsAg titer might be a good indicator of the off-treatment respo...
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Veröffentlicht in: | Clinical and molecular hepatology 2016-09, Vol.22 (3), p.382 |
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creator | Han Ah Lee Yeon Seok Seo Seung Woon Park Sang Jung Park Tae Hyung Kim Sang Jun Suh Young Kul Jung Ji Hoon Kim Hyunggin An Hyung Joon Yim Jong Eun Yeon Kwan Soo Byun Soon Ho Um |
description | Background/Aims: Clear indicators for stopping antiviral therapy in chronic hepatitis B (CHB) patients are not yet available. Since the level of hepatitis B surface antigen (HBsAg) is correlated with covalently closed circular DNA, the HBsAg titer might be a good indicator of the off-treatment response. This study aimed to determine the relationship between the HBsAg titer and the entecavir (ETV) off-treatment response. Methods: This study analyzed 44 consecutive CHB patients (age, 44.6±11.4 years, mean±SD; men, 63.6%; positive hepatitis B envelope antigen (HBeAg) at baseline, 56.8%; HBV DNA level, 6.8±1.3 log10 IU/mL) treated with ETV for a sufficient duration and in whom treatment was discontinued after HBsAg levels were measured. A virological relapse was defined as an increase in serum HBV DNA level of >2000 IU/mL, and a clinical relapse was defined as a virological relapse with a biochemical flare, defined as an increase in the serum alanine aminotransferase level of >2 × upper limit of normal. Results: After stopping ETV, virological relapse and clinical relapse were observed in 32 and 24 patients, respectively, during 20.8±19.9 months of follow-up. The cumulative incidence rates of virological relapse were 36.2% and 66.2%, respectively, at 6 and 12 months, and those of clinical relapse were 14.3% and 42.3%. The off-treatment HBsAg level was an independent factor associated with clinical relapse (hazard ratio, 2.251; 95% confidence interval, 1.076-4.706; P=0.031). When patients were grouped according to off-treatment HBsAg levels, clinical relapse did not occur in patients with an off-treatment HBsAg level of ≤2 log10 IU/mL (n=5), while the incidence rates of clinical relapse at 12 months after off-treatment were 28.4% and 55.7% in patients with off-treatment HBsAg levels of >2 and ≤3 log10 IU/mL (n=11) and >3 log 10 IU/mL (n=28), respectively. Conclusions: The off-treatment HBsAg level is closely related to clinical relapse after treatment cessation. A serum HBsAg level of |
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fullrecord | <record><control><sourceid>kiss</sourceid><recordid>TN_cdi_kiss_primary_3474714</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><kiss_id>3474714</kiss_id><sourcerecordid>3474714</sourcerecordid><originalsourceid>FETCH-kiss_primary_34747143</originalsourceid><addsrcrecordid>eNp9jUGKAjEQRbMYQVFP4KYu0KDdkbieQfEA7qVMV9rCNmmqouAB5t5GENy5-vDff_wfM6nrjatqV2_GZq7Kp6W1rmlWdj0x_3saMHNmhV_QmwT0BBgzdxSh9CRQEEKXUgscW_aYk0AK0N4ETz3BnQV7ENIhRS1ueDkUM3ksqCxDlYUwX0sHobj-LCmyh_PneWZGAXul-TunZrHbHv721YVVj4PwFeVxbKyzbmWb7_QJ-0ZNYg</addsrcrecordid><sourcetype>Publisher</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Hepatitis B surface antigen titer is a good indicator of durable viral response after entecavir off-treatment for chronic hepatitis B</title><source>ProQuest One Community College</source><source>KoreaMed Synapse</source><source>ProQuest Central (Alumni Edition)</source><source>DOAJ Directory of Open Access Journals</source><source>PubMed Central Open Access</source><source>KoreaMed Open Access</source><source>ProQuest Central UK/Ireland</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><source>ProQuest Central</source><creator>Han Ah Lee ; Yeon Seok Seo ; Seung Woon Park ; Sang Jung Park ; Tae Hyung Kim ; Sang Jun Suh ; Young Kul Jung ; Ji Hoon Kim ; Hyunggin An ; Hyung Joon Yim ; Jong Eun Yeon ; Kwan Soo Byun ; Soon Ho Um</creator><creatorcontrib>Han Ah Lee ; Yeon Seok Seo ; Seung Woon Park ; Sang Jung Park ; Tae Hyung Kim ; Sang Jun Suh ; Young Kul Jung ; Ji Hoon Kim ; Hyunggin An ; Hyung Joon Yim ; Jong Eun Yeon ; Kwan Soo Byun ; Soon Ho Um</creatorcontrib><description>Background/Aims: Clear indicators for stopping antiviral therapy in chronic hepatitis B (CHB) patients are not yet available. Since the level of hepatitis B surface antigen (HBsAg) is correlated with covalently closed circular DNA, the HBsAg titer might be a good indicator of the off-treatment response. This study aimed to determine the relationship between the HBsAg titer and the entecavir (ETV) off-treatment response. Methods: This study analyzed 44 consecutive CHB patients (age, 44.6±11.4 years, mean±SD; men, 63.6%; positive hepatitis B envelope antigen (HBeAg) at baseline, 56.8%; HBV DNA level, 6.8±1.3 log10 IU/mL) treated with ETV for a sufficient duration and in whom treatment was discontinued after HBsAg levels were measured. A virological relapse was defined as an increase in serum HBV DNA level of >2000 IU/mL, and a clinical relapse was defined as a virological relapse with a biochemical flare, defined as an increase in the serum alanine aminotransferase level of >2 × upper limit of normal. Results: After stopping ETV, virological relapse and clinical relapse were observed in 32 and 24 patients, respectively, during 20.8±19.9 months of follow-up. The cumulative incidence rates of virological relapse were 36.2% and 66.2%, respectively, at 6 and 12 months, and those of clinical relapse were 14.3% and 42.3%. The off-treatment HBsAg level was an independent factor associated with clinical relapse (hazard ratio, 2.251; 95% confidence interval, 1.076-4.706; P=0.031). When patients were grouped according to off-treatment HBsAg levels, clinical relapse did not occur in patients with an off-treatment HBsAg level of ≤2 log10 IU/mL (n=5), while the incidence rates of clinical relapse at 12 months after off-treatment were 28.4% and 55.7% in patients with off-treatment HBsAg levels of >2 and ≤3 log10 IU/mL (n=11) and >3 log 10 IU/mL (n=28), respectively. Conclusions: The off-treatment HBsAg level is closely related to clinical relapse after treatment cessation. A serum HBsAg level of <2 log 10 IU/mL is an excellent predictor of a sustained off-treatment response in CHB patients who have received ETV for a sufficient duration. (Clin Mol Hepatol 2016;22:382-389)</description><identifier>ISSN: 2287-2728</identifier><language>kor</language><publisher>대한간학회</publisher><subject>Hepatitis B surface antigen ; Hepatitis B virus ; Off-treatment ; Relapse</subject><ispartof>Clinical and molecular hepatology, 2016-09, Vol.22 (3), p.382</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784</link.rule.ids></links><search><creatorcontrib>Han Ah Lee</creatorcontrib><creatorcontrib>Yeon Seok Seo</creatorcontrib><creatorcontrib>Seung Woon Park</creatorcontrib><creatorcontrib>Sang Jung Park</creatorcontrib><creatorcontrib>Tae Hyung Kim</creatorcontrib><creatorcontrib>Sang Jun Suh</creatorcontrib><creatorcontrib>Young Kul Jung</creatorcontrib><creatorcontrib>Ji Hoon Kim</creatorcontrib><creatorcontrib>Hyunggin An</creatorcontrib><creatorcontrib>Hyung Joon Yim</creatorcontrib><creatorcontrib>Jong Eun Yeon</creatorcontrib><creatorcontrib>Kwan Soo Byun</creatorcontrib><creatorcontrib>Soon Ho Um</creatorcontrib><title>Hepatitis B surface antigen titer is a good indicator of durable viral response after entecavir off-treatment for chronic hepatitis B</title><title>Clinical and molecular hepatology</title><addtitle>Clinical and Molecular Hepatology(대한간학회지)</addtitle><description>Background/Aims: Clear indicators for stopping antiviral therapy in chronic hepatitis B (CHB) patients are not yet available. Since the level of hepatitis B surface antigen (HBsAg) is correlated with covalently closed circular DNA, the HBsAg titer might be a good indicator of the off-treatment response. This study aimed to determine the relationship between the HBsAg titer and the entecavir (ETV) off-treatment response. Methods: This study analyzed 44 consecutive CHB patients (age, 44.6±11.4 years, mean±SD; men, 63.6%; positive hepatitis B envelope antigen (HBeAg) at baseline, 56.8%; HBV DNA level, 6.8±1.3 log10 IU/mL) treated with ETV for a sufficient duration and in whom treatment was discontinued after HBsAg levels were measured. A virological relapse was defined as an increase in serum HBV DNA level of >2000 IU/mL, and a clinical relapse was defined as a virological relapse with a biochemical flare, defined as an increase in the serum alanine aminotransferase level of >2 × upper limit of normal. Results: After stopping ETV, virological relapse and clinical relapse were observed in 32 and 24 patients, respectively, during 20.8±19.9 months of follow-up. The cumulative incidence rates of virological relapse were 36.2% and 66.2%, respectively, at 6 and 12 months, and those of clinical relapse were 14.3% and 42.3%. The off-treatment HBsAg level was an independent factor associated with clinical relapse (hazard ratio, 2.251; 95% confidence interval, 1.076-4.706; P=0.031). When patients were grouped according to off-treatment HBsAg levels, clinical relapse did not occur in patients with an off-treatment HBsAg level of ≤2 log10 IU/mL (n=5), while the incidence rates of clinical relapse at 12 months after off-treatment were 28.4% and 55.7% in patients with off-treatment HBsAg levels of >2 and ≤3 log10 IU/mL (n=11) and >3 log 10 IU/mL (n=28), respectively. Conclusions: The off-treatment HBsAg level is closely related to clinical relapse after treatment cessation. A serum HBsAg level of <2 log 10 IU/mL is an excellent predictor of a sustained off-treatment response in CHB patients who have received ETV for a sufficient duration. (Clin Mol Hepatol 2016;22:382-389)</description><subject>Hepatitis B surface antigen</subject><subject>Hepatitis B virus</subject><subject>Off-treatment</subject><subject>Relapse</subject><issn>2287-2728</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNp9jUGKAjEQRbMYQVFP4KYu0KDdkbieQfEA7qVMV9rCNmmqouAB5t5GENy5-vDff_wfM6nrjatqV2_GZq7Kp6W1rmlWdj0x_3saMHNmhV_QmwT0BBgzdxSh9CRQEEKXUgscW_aYk0AK0N4ETz3BnQV7ENIhRS1ueDkUM3ksqCxDlYUwX0sHobj-LCmyh_PneWZGAXul-TunZrHbHv721YVVj4PwFeVxbKyzbmWb7_QJ-0ZNYg</recordid><startdate>20160930</startdate><enddate>20160930</enddate><creator>Han Ah Lee</creator><creator>Yeon Seok Seo</creator><creator>Seung Woon Park</creator><creator>Sang Jung Park</creator><creator>Tae Hyung Kim</creator><creator>Sang Jun Suh</creator><creator>Young Kul Jung</creator><creator>Ji Hoon Kim</creator><creator>Hyunggin An</creator><creator>Hyung Joon Yim</creator><creator>Jong Eun Yeon</creator><creator>Kwan Soo Byun</creator><creator>Soon Ho Um</creator><general>대한간학회</general><scope>HZB</scope><scope>Q5X</scope></search><sort><creationdate>20160930</creationdate><title>Hepatitis B surface antigen titer is a good indicator of durable viral response after entecavir off-treatment for chronic hepatitis B</title><author>Han Ah Lee ; Yeon Seok Seo ; Seung Woon Park ; Sang Jung Park ; Tae Hyung Kim ; Sang Jun Suh ; Young Kul Jung ; Ji Hoon Kim ; Hyunggin An ; Hyung Joon Yim ; Jong Eun Yeon ; Kwan Soo Byun ; Soon Ho Um</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-kiss_primary_34747143</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>kor</language><creationdate>2016</creationdate><topic>Hepatitis B surface antigen</topic><topic>Hepatitis B virus</topic><topic>Off-treatment</topic><topic>Relapse</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Han Ah Lee</creatorcontrib><creatorcontrib>Yeon Seok Seo</creatorcontrib><creatorcontrib>Seung Woon Park</creatorcontrib><creatorcontrib>Sang Jung Park</creatorcontrib><creatorcontrib>Tae Hyung Kim</creatorcontrib><creatorcontrib>Sang Jun Suh</creatorcontrib><creatorcontrib>Young Kul Jung</creatorcontrib><creatorcontrib>Ji Hoon Kim</creatorcontrib><creatorcontrib>Hyunggin An</creatorcontrib><creatorcontrib>Hyung Joon Yim</creatorcontrib><creatorcontrib>Jong Eun Yeon</creatorcontrib><creatorcontrib>Kwan Soo Byun</creatorcontrib><creatorcontrib>Soon Ho Um</creatorcontrib><collection>Korean Studies Information Service System (KISS)</collection><collection>Korean Studies Information Service System (KISS) B-Type</collection><jtitle>Clinical and molecular hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Han Ah Lee</au><au>Yeon Seok Seo</au><au>Seung Woon Park</au><au>Sang Jung Park</au><au>Tae Hyung Kim</au><au>Sang Jun Suh</au><au>Young Kul Jung</au><au>Ji Hoon Kim</au><au>Hyunggin An</au><au>Hyung Joon Yim</au><au>Jong Eun Yeon</au><au>Kwan Soo Byun</au><au>Soon Ho Um</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hepatitis B surface antigen titer is a good indicator of durable viral response after entecavir off-treatment for chronic hepatitis B</atitle><jtitle>Clinical and molecular hepatology</jtitle><addtitle>Clinical and Molecular Hepatology(대한간학회지)</addtitle><date>2016-09-30</date><risdate>2016</risdate><volume>22</volume><issue>3</issue><spage>382</spage><pages>382-</pages><issn>2287-2728</issn><abstract>Background/Aims: Clear indicators for stopping antiviral therapy in chronic hepatitis B (CHB) patients are not yet available. Since the level of hepatitis B surface antigen (HBsAg) is correlated with covalently closed circular DNA, the HBsAg titer might be a good indicator of the off-treatment response. This study aimed to determine the relationship between the HBsAg titer and the entecavir (ETV) off-treatment response. Methods: This study analyzed 44 consecutive CHB patients (age, 44.6±11.4 years, mean±SD; men, 63.6%; positive hepatitis B envelope antigen (HBeAg) at baseline, 56.8%; HBV DNA level, 6.8±1.3 log10 IU/mL) treated with ETV for a sufficient duration and in whom treatment was discontinued after HBsAg levels were measured. A virological relapse was defined as an increase in serum HBV DNA level of >2000 IU/mL, and a clinical relapse was defined as a virological relapse with a biochemical flare, defined as an increase in the serum alanine aminotransferase level of >2 × upper limit of normal. Results: After stopping ETV, virological relapse and clinical relapse were observed in 32 and 24 patients, respectively, during 20.8±19.9 months of follow-up. The cumulative incidence rates of virological relapse were 36.2% and 66.2%, respectively, at 6 and 12 months, and those of clinical relapse were 14.3% and 42.3%. The off-treatment HBsAg level was an independent factor associated with clinical relapse (hazard ratio, 2.251; 95% confidence interval, 1.076-4.706; P=0.031). When patients were grouped according to off-treatment HBsAg levels, clinical relapse did not occur in patients with an off-treatment HBsAg level of ≤2 log10 IU/mL (n=5), while the incidence rates of clinical relapse at 12 months after off-treatment were 28.4% and 55.7% in patients with off-treatment HBsAg levels of >2 and ≤3 log10 IU/mL (n=11) and >3 log 10 IU/mL (n=28), respectively. Conclusions: The off-treatment HBsAg level is closely related to clinical relapse after treatment cessation. A serum HBsAg level of <2 log 10 IU/mL is an excellent predictor of a sustained off-treatment response in CHB patients who have received ETV for a sufficient duration. (Clin Mol Hepatol 2016;22:382-389)</abstract><pub>대한간학회</pub><tpages>8</tpages></addata></record> |
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subjects | Hepatitis B surface antigen Hepatitis B virus Off-treatment Relapse |
title | Hepatitis B surface antigen titer is a good indicator of durable viral response after entecavir off-treatment for chronic hepatitis B |
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