Interferon therapy in HBeAg positive chronic hepatitis reduces progression to cirrhosis and hepatocellular carcinoma

Lin, Shi‐Ming; Yu, Ming‐Lung; Lee, Chuan–Mo; Chien, Rong‐Nan; Sheen, I‐Shyan; Chu, Chia–Ming; Liaw, Yun–Fan

doi:10.1016/j.jhep.2006.08.021

Cited by 288 publications

(282 citation statements)

References 35 publications

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“…A more recent long-term follow-up study also showed that patients with persistent HBeAg seropositivity had a much higher incidence of liver cirrhosis (Fig. 2) [14]. This is supported by evidence from studies of asymptomatic, HBeAg-positive HBV carriers that persistent HBeAg positivity or a prolonged immune clearance phase is associated with a higher risk of developing cirrhosis [10,11].…”

Section: Hbeag Positivity and Disease Progressionmentioning

confidence: 62%

“…Patients who undergo HBeAg seroconversion are more likely to experience improved long-term outcomes, including disease remission, a lower incidence of cirrhosis and HCC, increased rates of survival, and the possibility of HBsAg loss or seroconversion [8,14,40]. For example, the beneficial effects of HBeAg seroconversion were investigated by Hsu and colleagues [8] in a study involving 283 patients with CHB who underwent spontaneous HBeAg .82) were associated with a higher risk of developing cirrhosis than with sustained HBeAg seroconversion [8].…”

Section: Hbeag Positivity and Disease Progressionmentioning

confidence: 99%

“…In contrast, only 7 of the 50 untreated individuals experienced spontaneous HBeAg conversion (cumulative rate of 28% at 5 years), and all remained positive for HBsAg. Of the 50 treated patients with persistent HBeAg positivity, 6 patients died of liver failure, 2 patients required liver transplantation, and 8 Adapted from Lin et al [14] with permission patients developed cirrhosis during follow-up. Overall survival and survival without clinical complications were significantly longer in patients who experienced HBeAg seroconversion after therapy with IFN-a than in those who remained HBeAg positive (P = 0.004 and P = 0.018, respectively) [12].…”

Section: Treatment-induced Hbeag Seroconversion and Disease Progressionmentioning

confidence: 99%

“…In a more recent study, Lin and colleagues [14] reported the long-term outcomes of IFN-a therapy involving 233 HBeAg seropositive patients and 233 well-matched untreated controls who were followed for 15 years. In this study, IFN-a-treated patients had a higher cumulative incidence of HBeAg seroconversion and a lower incidence of cirrhosis and HCC than for untreated controls at the end of 15 years of follow-up (median = 6.8 years; range = 1.1-16.5 years) ( Table 1) [14].…”

Section: Treatment-induced Hbeag Seroconversion and Disease Progressionmentioning

confidence: 99%

“…Spontaneous loss of HBeAg and development of antibodies to HBeAg (anti-HBe), referred to as HBeAg seroconversion, are associated with low HBV-DNA levels and clinical remission of liver disease in the majority of patients [8][9][10][11]. Earlier HBeAg seroconversion, or a shorter HBeAg-positive phase, is associated with a higher chance of sustained remission, lower rate of HBeAg reversion, and slower progression of liver disease and even increased hepatitis B surface antigen (HBsAg) seroclearance [10][11][12][13][14].…”

Section: Introductionmentioning

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: Hbeag Positivity and Disease Progressionmentioning

confidence: 62%

Section: Hbeag Positivity and Disease Progressionmentioning

confidence: 99%

Section: Treatment-induced Hbeag Seroconversion and Disease Progressionmentioning

confidence: 99%

Section: Treatment-induced Hbeag Seroconversion and Disease Progressionmentioning

confidence: 99%

Section: Introductionmentioning

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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Role of Hepatitis B Virus Infection in the Prognosis After Hepatectomy for Hepatocellular Carcinoma in Patients With Cirrhosis

Cescon¹

2009

Arch Surg

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Infection with HBV is a strong predictive factor for lower RFS after hepatectomy for a single nodule of HCC of 5 cm or smaller in patients with cirrhosis, providing a further basis for adjuvant antiviral treatment. Patients who are seropositive for HBV with poorly differentiated HCC should also be considered to be at a high risk of recurrence and possibly included in a policy of salvage liver transplantation.

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Chronic Hepatitis B Infection

Tang

Covert

Wilson

et al. 2018

JAMA

537

473

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Antiviral treatment with either pegylated interferon or a nucleos(t)ide analogue (lamivudine, adefovir, entecavir, tenofovir disoproxil, or tenofovir alafenamide) should be offered to patients with chronic HBV infection and liver inflammation in an effort to reduce progression of liver disease. Nucleos(t)ide analogues should be considered as first-line therapy. Because cure rates are low, most patients will require therapy indefinitely.

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Interferon therapy in HBeAg positive chronic hepatitis reduces progression to cirrhosis and hepatocellular carcinoma

Cited by 288 publications

References 35 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

Role of Hepatitis B Virus Infection in the Prognosis After Hepatectomy for Hepatocellular Carcinoma in Patients With Cirrhosis

Chronic Hepatitis B Infection

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