706 Sustained Durability of Hbeag Seroconversion in Chronic Hepatitis B Patients After Treatment With Telbivudine

Poynard, T.; Hou, Jinlin; Chutaputti, Anuchit; Manns, MP; Naoumov, Nikolai V.

doi:10.1016/s0168-8278(08)60708-4

Cited by 14 publications

(10 citation statements)

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“…The off-treatment durability of HBeAg seroconversion was recently assessed in more than 1,000 HBeAg-positive patients who participated in two pivotal phase III studies comparing the safety and efficacy of telbivudine and lamivudine over a 2-year period in adult patients with CHB [53,56]. The GLOBE study, conducted in 20 countries, compared these two antiviral agents in 1,367 patients (921 HBeAg positive) [22].…”

Section: Treatment-induced Hbeag Seroconversion and Disease Progressionmentioning

confidence: 99%

“…4b) at each study visit and thus met the criteria for treatment discontinuation [53]. The post-treatment durability of HBeAg seroconversion with telbivudine by Kaplan-Meier estimate during the follow-up period was 98, 94, and 86% after 12, 24, and 52 weeks, respectively [56]. In contrast, the off-treatment durability of HBeAg seroconversion for patients treated with entecavir at week 96 was only 77% [23].…”

Section: Treatment-induced Hbeag Seroconversion and Disease Progressionmentioning

confidence: 99%

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HBeAg seroconversion as an important end point in the treatment of chronic hepatitis B

2009

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During the natural history of chronic hepatitis B virus (HBV) infection, the loss of serum hepatitis B e antigen (HBeAg) and the development of anti-HBe antibodies (HBeAg seroconversion) mark a transition from the immune-active phase of disease to the inactive carrier state. This review examines the evidence from natural history and cohort studies on the relationship between HBeAg seroconversion and disease progression. The role of HBeAg seroconversion as an important milestone in the management of HBeAg-positive patients with chronic hepatitis B (CHB), as well as the advantages and disadvantages of administering a finite course of therapy for HBeAg-positive CHB, is also discussed. The evidence from natural history and cohort studies indicates that spontaneous or treatment-induced HBeAg seroconversion is associated with lower rates of disease progression to cirrhosis and hepatocellular carcinoma, a potential of hepatitis B surface antigen seroconversion, and improved survival rates. Updated guidelines developed by major liver associations recommend stopping oral therapy for HBeAgpositive patients who achieve sustained HBeAg seroconversion with polymerase chain reaction-undetectable HBV-DNA on two separate occasions for 6 or more months apart, taking into consideration the individual's clinical and virologic response to therapy, as well as the severity of liver disease. Thus, early induction of HBeAg seroconversion with interferon-based therapy or oral nucleos(t)ide analogues has important clinical and socioeconomic implications for the management of CHB.

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Section: Treatment-induced Hbeag Seroconversion and Disease Progressionmentioning

confidence: 99%

Section: Treatment-induced Hbeag Seroconversion and Disease Progressionmentioning

confidence: 99%

HBeAg seroconversion as an important end point in the treatment of chronic hepatitis B

2009

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“…Most prior studies have examined post-seroconversion relapse rates and their predictors in patients treated with lamivudine (LAM). In predominantly Caucasian CHB cohorts, there have been reports of durable seroconversion in 80–90 % of patients [6, 7], whereas in Asian studies relapse rates as high as 68 % have been reported [8]. Overall, in Asian patients, NA-induced HBeAg seroconversion seems more difficult to achieve [9] and less durable after discontinuation of treatment, and disease relapse is more frequent [5, 8, 10–15].…”

Section: Introductionmentioning

confidence: 99%

Durability of Hepatitis B e Antigen Seroconversion in Chronic Hepatitis B Patients Treated with Entecavir or Tenofovir

Fong

Tien

et al. 2015

Dig Dis Sci

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Introduction Loss of HBeAg and development of anti-HBe (seroconversion) is seen as a milestone and endpoint in the treatment of HBeAg-positive patients with chronic hepatitis B (CHB). Among patients treated with nucleos (t)ide analogs (NA), recurrent viremia is common after discontinuation of therapy. Entecavir (ETV) and tenofovir (TDF) are highly potent NA. The durability of virological response and HBeAg seroconversion in patients treated with these agents is not well studied. Methods We retrospectively studied the outcomes of 54 HBeAg-positive CHB patients who were treated with either ETV (n = 30) or TDF (23) or both (n = 1) that achieved virological response and underwent seroconversion and consolidation therapy before cessation of treatment. Results Only 4 (7 %) patients had sustained virological, serological, and biochemical remission. Thirteen patients (24 %) continued to have HBV DNA levels below 2000 IU/mL and normal alanine aminotransferase activity (ALT). Thirty-seven patients (69 %) developed HBV DNA >2000 IU/mL, with 20 having elevated ALT. Among these 37 patients, 23 (62 %) remained HBeAg negative/anti-HBe positive, 12 (32 %) became HBeAg positive, and 2 (5 %) were HBeAg and anti-HBe negative. Duration of consolidation therapy did not correlate with low versus high level of virological relapse. Conclusions Durability of HBeAg seroconversion associated with ETV or TDF was not superior to that reported in patients treated with less potent NA. Our results, aggregated with others, suggest HBeAg seroconversion should not be considered as a treatment endpoint for most HBeAg-positive patients treated with NA. Future updates of treatment guidelines should reconsider HBeAg seroconversion as an endpoint to therapy.

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“…Limited data are available on the off‐treatment durability of HBeAg seroconversion achieved with the newer NAs. In a pooled analysis that assessed the durability of HBeAg seroconversion among HBeAg‐positive patients who participated in GLOBE and study 015 and discontinued telbivudine treatment because of efficacy (i.e., they received ≥1 year of antiviral treatment and had HBV DNA <5 log 10 copies/ml, with HBeAg loss maintained on treatment for ≥24 weeks), the post‐treatment durability of HBeAg seroconversion with telbivudine was >85% by a Kaplan–Meier estimate after 52 weeks of off‐treatment follow‐up (47, 75). The off‐treatment durability of HBeAg seroconversion for entecavir‐treated patients with HBeAg‐positive CHB who participated in a registrational phase III trial and discontinued treatment because of efficacy was 77% at week 96 (20).…”

Section: Durability Of Seroconversionmentioning

confidence: 99%

Current treatments for patients with HBeAg-positive chronic hepatitis B virus infection: a comparison focusing on HBeAg seroconversion

Lau

2010

Liver International

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HBeAg seroconversion, in association with undetectable levels of hepatitis B virus DNA as determined by polymerase chain reaction, is an important goal in the treatment of patients with HBeAg-positive chronic hepatitis B (CHB). Achievement of sustained HBeAg seroconversion at an early age ( o40 years) is associated with a reduced incidence of hepatic complications, increased rates of HBsAg loss and seroconversion and improved survival rates, whether the seroconversion is spontaneous or treatment induced. Patients with HBeAgpositive CHB who achieve sustained HBeAg seroconversion and complete 6-12 months of consolidation therapy are eligible for stopping therapy. In randomized clinical studies involving patients with HBeAg-positive CHB, treatment with pegylated interferon (PegIFN)-a is associated with higher and more durable HBeAg seroconversion rates than are lamivudine and adefovir. More recently, newer generation oral nucleos(t)ide analogs (NAs) have become available. These include entecavir, telbivudine and tenofovir, and they demonstrate superior antiviral potency and efficacy. This review examines the importance of HBeAg seroconversion as an end point for therapy in the treatment of patients with HBeAg-positive CHB, and examines the rates and durability of HBeAg seroconversion with PegIFN and oral NA therapy. The mechanisms for enhanced HBeAg seroconversion rates with new-generation NAs are also discussed.

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706 Sustained Durability of Hbeag Seroconversion in Chronic Hepatitis B Patients After Treatment With Telbivudine

Cited by 14 publications

References 0 publications

HBeAg seroconversion as an important end point in the treatment of chronic hepatitis B

HBeAg seroconversion as an important end point in the treatment of chronic hepatitis B

Durability of Hepatitis B e Antigen Seroconversion in Chronic Hepatitis B Patients Treated with Entecavir or Tenofovir

Current treatments for patients with HBeAg-positive chronic hepatitis B virus infection: a comparison focusing on HBeAg seroconversion

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