HBsAg level and clinical course in patients with chronic hepatitis B treated with nucleoside analogue: five years of follow-up data
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background/Aims: Quantification of the hepatitis B surface antigen (HBsAg) is increasingly used to determine the treatment response in patients with chronic hepatitis B (CHB). However, there are limited data about the clinical implications of Quantification of HBsAg long-term nucleoside analogue treatment for CHB. We investigated the clinical correlation between HBsAg level and clinical course in patients with CHB who are treated long-term with nucleoside analogues. Methods: Patients with CHB who started lamivudine or entecavir monotherapy before June 2007 were enrolled. HBsAg was quantified at baseline, at 6 months, and at 1, 2, 3, 4, and 5 years of treatment. We compared data between the groups according to the presence or absence of a virological response (VR) and resistance. Results: Forty-eight patients were analyzed. There was no definite reduction in HBsAg level during the early period of treatment; differences in HBsAg levels between baseline and each time point were significant only at 5 years (P=0.028). In a subgroup analysis, this difference was significant only in non-resistant patients at 5 years (P=0.041). Conclusions: There was no definite decrease in the HBsAg level during the early period of nucleoside analogue treatment, with long-term treatment being required to observe a significant reduction. (Clin Mol Hepatol 2013;19:409-416)
Abstract
Background/Aims: Quantification of the hepatitis B surface antigen (HBsAg) is increasingly used to determine the treatment response in patients with chronic hepatitis B (CHB). However, there are limited data about the clinical implications of Quantification of HBsAg long-term nucleoside analogue treatment for CHB. We investigated the clinical correlation between HBsAg level and clinical course in patients with CHB who are treated long-term with nucleoside analogues. Methods: Patients with CHB who started lamivudine or entecavir monotherapy before June 2007 were enrolled. HBsAg was quantified at baseline, at 6 months, and at 1, 2, 3, 4, and 5 years of treatment. We compared data between the groups according to the presence or absence of a virological response (VR) and resistance. Results: Forty-eight patients were analyzed. There was no definite reduction in HBsAg level during the early period of treatment; differences in HBsAg levels between baseline and each time point were significant only at 5 years (P=0.028). In a subgroup analysis, this difference was significant only in non-resistant patients at 5 years (P=0.041). Conclusions: There was no definite decrease in the HBsAg level during the early period of nucleoside analogue treatment, with long-term treatment being required to observe a significant reduction. (Clin Mol Hepatol 2013;19:409-416)
참고문헌 (21)
- Moucari R, "Early serum HBsAg drop: A strong predictor of sustained virological response to pegylated interferon alfa-2a in HBeAg-negative patients", Hepatology, 49, pp.1151~1157 (2009)
- Perrillo R, "Editorial: Measurement of HBsAg concentration during antiviral therapy of hepatitis B: Who, when, and why", Am J Gastroenterol, 106, pp.1774~1776 (2011)
- Brunetto MR, "Hepatitis B virus surface antigen levels: A guide to sustained response to peginterferon alfa-2a in HBeAg-negative chronic hepatitis B", Hepatology, 49, pp.1141~1150 (2009)
- Jung YK, "Change in serum hepatitis B surface antigen level and its clinical significance in treatment-naive, hepatitis B e antigen-positive patients receiving entecavir", J Clin Gastroenterol, 44, pp.653~657 (2010)
- Lee JM, "Quantitative hepatitis B surface antigen and hepatitis B e antigen titers in prediction of treatment response to entecavir", Hepatology, 53, pp.1486~1493 (2011)
- Yeon JE, "Resistance to adefovir dipivoxil in lamivudine resistant chronic hepatitis B patients treated with adefovir dipivoxil", Gut, 55, pp.1488~1495 (2006)
- Sang Soo Lee, "Type and cause of liver disease in Korea: single-center experience, 2005-2010", Clinical and Molecular Hepatology, 18(3), pp.309~315 (2012), 대한간학회
- Chae HB, "Current status of liver diseases in Korea: Hepatitis B", Korean J Hepatol, 15(Suppl 6), pp.S13~S24 (2009)
- Rotman Y, "Evaluation of the patient with hepatitis B", Hepatology, 49, pp.S22~S27 (2009)
- Janssen HL, "Quantification of serum hepatitis B surface antigen: is it useful for the management of chronic hepatitis B?", Gut, 61, pp.641~645 (2012)
- Wursthorn K, "Peginterferon alpha-2b plus adefovir induce strong cccDNA decline and HBsAg reduction in patients with chronic hepatitis B", Hepatology, 44, pp.675~684 (2006)
- Chan HL, "Serum hepatitis B surface antigen quantitation can reflect hepatitis B virus in the liver and predict treatment response", Clin Gastroenterol Hepatol, 5, pp.1462~1468 (2007)
- Janssen HL, "Measurement of HBsAg to monitor hepatitis B viral replication in patients on alpha-interferon therapy", Antiviral Res, 23, pp.251~257 (1994)
- Reijnders JG, "Kinetics of hepatitis B surface antigen differ between treatment with peginterferon and entecavir", J Hepatol, 54, pp.449~454 (2011)
- Borgniet O, "Clearance of serum HBsAg and anti-HBs seroconversion following antiviral therapy for chronic hepatitis B", J Med Virol, 81, pp.1336~1342 (2009)
- The Korean Association for the Study of the Liver, "KASL Clinical Practice Guidelines: Management of chronic hepatitis B", Clin Mol Hepatol, 18, pp.109~162 (2012)
- European Association For The Study Of The Liver, "EASL clinical practice guidelines: Management of chronic hepatitis B virus infec.tion", J Hepatol, 57, pp.167~185 (2012)
- Lok AS, "Chronic hepatitis B: Update 2009", Hepatology, 50, pp.661~662 (2009)
- Fung J, "Quantitative hepatitis B surface antigen levels in patients with chronic hepatitis B after 2 years of entecavir treatment", Am J Gastroenterol, 106, pp.1766~1773 (2011)
- Zoulim F, "Hepatitis B virus resistance to nucleos(t)ide analogues", Gastroenterology, 137, pp.1593~1608 (2009)
- Fasano M, "HBV DNA suppression and HBsAg clearance in HBeAg negative chronic hepatitis B patients on lamivudine therapy for over 5 years", J Hepatol, 56, pp.1254~1258 (2012)
