1006 Hbsag Kinetics of Decay and Baseline Characteristics of Hbeag-Positive Patients With Chronic Hepatitis B Following 3 Years of Tenofovir Disoproxil Fumarate (Tdf) Treatment

Gane, E.; Heathcote, E.J.; Marcellin, Patrick; Dusheiko, G.; Jacobson, Ira M.; Man, RA de; Zeuzem, Stefan; Nikolaidis, P.; Sorbel, J.; Mondou, Elsa; Anderson, Jane; Rousseau, Franck

doi:10.1016/s0168-8278(10)61007-0

Cited by 14 publications

(16 citation statements)

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“…It was reported that HBsAg seroclearance was 7% among HBeAg-positive patients after 52 weeks on pegylated interferon (14); 5% to 8% after 2-5 years of entecavir monotherapy (21,22); and 1.4% to 10% after 3-4 years of tenofovir monotherapy (23,24). LAM or ADV are no longer used as monotherapy regimens since the advent of tenofovir or entecavir; therefore, in this study, therapeutic efficacy was compared between PEG-IFNα combined with LAM or ADV and PEG-IFNα monotherapy using a meta-analysis of clinical data from 14 eligible trials.…”

Section: Discussionmentioning

confidence: 99%

HBsAg seroclearance or seroconversion induced by peg-interferon alpha and lamivudine or adefovir combination therapy in chronic hepatitis B treatment: a meta-analysis and systematic review

Zhang¹,

Chen²,

Chi³

et al. 2016

Rev Esp Enferm Dig

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Background and aims: Seroclearance or seroconversion of hepatitis B surface antigen (HBsAg) is generally considered as a clinical endpoint. The purpose of the present meta-analysis was to evaluate the effect of combined therapy with pegylated interferon alpha (PEG-IFNα) with or without lamivudine (LAM) or adefovir (ADV) on HBsAg seroclearance or seroconversion in subjects with chronic hepatitis B (CHB).Methods: Randomized controlled trials performed through May 30 th 2015 in adults with CHB receiving PEG-IFNα and LAM or ADV combination therapy or monotherapy for 48-52 weeks were included. The Review Manager Software 5.2.0 was used for the meta-analysis.Results: No statistical differences in HBsAg seroclearance (9.9% vs. 7.1%, OR = 1.47, 95% CI: 0.75, 2.90; p = 0.26) or HBsAg seroconversion (4.2% vs. 3.7%, OR = 1.17, 95% CI: 0.57, 2.37; p = 0.67) rates were noticed between PEG-IFNα + LAM and PEG-IFN α + placebo during post-treatment follow-up for 24-26-weeks in subjects with hepatitis Be antigen (HBeAg)-positive CHB.No statistical differences in HBsAg clearance (10.5% vs. 6.4%, OR = 1.68, 95% CI: 0.75, 3.76; p = 0.21) were seen, but statistical differences in HBsAg seroconversion (6.3% vs. 0%, OR = 7.22, 95% CI: 1.23, 42.40; p = 0.03) were observed, between PEG-IFNα + ADV and PEG-IFNα for 48-52 weeks of treatment in subjects with HBeAg-positive CHB.A systematic evaluation showed no differences in HBsAg disappearance and seroconversion rates between PEG-IFNα + placebo and PEG-IFNα + LAM for 48-52 weeks in subjects with HBeAg-positive CHB.A systematic assessment found no differences in HBsAg disappearance and seroconversion rates between PEG-IFNα + placebo and PEG-IFNα + LAM during 24 weeks' to 3 years' followup after treatment in subjects with HBeAg-negative CHB.Conclusion: Combined therapy with PEG-IFNα and LAM or ADV was not superior to monotherapy with PEG-IFNα in terms of HBsAg seroclearance or seroconversion

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Section: Discussionmentioning

confidence: 99%

HBsAg seroclearance or seroconversion induced by peg-interferon alpha and lamivudine or adefovir combination therapy in chronic hepatitis B treatment: a meta-analysis and systematic review

Zhang¹,

Chen²,

Chi³

et al. 2016

Rev Esp Enferm Dig

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“…The HBsAg loss rates for HBeAg-positive patients treated with entecavir or lamivudine for 2 years were 5 and 3 %, respectively [60]. For HBeAg-positive patients receiving telbivudine and tenofovir therapy, a rapid decline of the HBsAg level during the first year of therapy was associated with a higher probability of HBsAg loss [56, 61]. Of note, the correlation between HBsAg decline and HBsAg loss in NUC users is in line with what we have observed in the natural history: the greater the decline of HBsAg, the higher is the chance of spontaneous HBsAg loss.…”

Section: Qhbsag and Nuc Therapymentioning

confidence: 99%

Clinical utility of quantitative HBsAg in natural history and nucleos(t)ide analogue treatment of chronic hepatitis B: new trick of old dog

2012

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Using commercial quantitative assays, quantitative hepatitis B surface antigen (qHBsAg) has improved our understanding and management of chronic hepatitis B (CHB). The HBsAg level is highest in the immune tolerance phase, starts to decline during the immune clearance phase, and decreases slowly but progressively after hepatitis B e antigen (HBeAg) seroconversion. The HBsAg level is lowest in individuals with an inactive carrier state but higher in those who develop HBeAg-negative hepatitis. It has been shown that a reduction of HBsAg by 1 log IU/mL or more reflects improved host immune control of HBV infection. A combination of HBsAg <1000 IU/mL and HBV-DNA <2000 IU/mL can identify a 3-year inactive state in a genotype D HBeAg-negative carrier population. In the Asian-Pacific region, where HBV genotypes B and C are dominant, HBsAg levels of ≤10–100 IU/mL predict HBsAg loss over time. As to the prediction of disease progression, low-viremic carriers with HBsAg >1000 IU/mL have been shown to be at higher risks of HBeAg-negative hepatitis, cirrhosis, and hepatocellular carcinoma than those with HBsAg <1000 IU/mL. Although qHBsAg has been widely used in CHB patients receiving pegylated interferon therapy, the HBsAg decline is slow and does not correlate with HBV-DNA levels during nucleos(t)ide analogue (NUC) therapy. However, a rapid HBsAg decline during NUC therapy may identify patients who will finally clear HBsAg. A 6- to 12-monthly assessment of HBsAg level could be considered during NUC therapy. Taking these lines of evidence together, qHBsAg can complement HBV-DNA levels to optimize the management of CHB patients in our daily clinical practice.

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“…During treatment with telbivudine (TdT), adefovir dipivoxil (ADV) and tenofovir disoproxil fumarate (TDF) , different qHBsAg kinetics were reported for HBeAg+ and HBeAg− patients. Changes of qHBsAg varied, but significant decreases were demonstrated only in HBeAg+ patients, whereas in HBeAg− patients no significant differences between levels of qHBsAg at baseline and after 2–3 years of treatment have been found .…”

mentioning

confidence: 98%

Kinetics and prediction of HBsAg loss during therapy with analogues in patients affected by chronic hepatitis B HBeAg negative and genotype D

Boglione

D’Avolio

Castaldo

et al. 2013

Liver International

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1006 Hbsag Kinetics of Decay and Baseline Characteristics of Hbeag-Positive Patients With Chronic Hepatitis B Following 3 Years of Tenofovir Disoproxil Fumarate (Tdf) Treatment

Cited by 14 publications

References 0 publications

HBsAg seroclearance or seroconversion induced by peg-interferon alpha and lamivudine or adefovir combination therapy in chronic hepatitis B treatment: a meta-analysis and systematic review

HBsAg seroclearance or seroconversion induced by peg-interferon alpha and lamivudine or adefovir combination therapy in chronic hepatitis B treatment: a meta-analysis and systematic review

Clinical utility of quantitative HBsAg in natural history and nucleos(t)ide analogue treatment of chronic hepatitis B: new trick of old dog

Kinetics and prediction of HBsAg loss during therapy with analogues in patients affected by chronic hepatitis B HBeAg negative and genotype D

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