The long-term course of chronic hepatitis B

Marco, Vito Di; Iacono, Oreste Lo; Cammà, Calogero; Vaccaro, Alessandra; Giunta, Marco; Martorana, Giuseppe; Fuschi, Patrizia; Almasio, Piero Luigi; Craxı̀, Antonio

doi:10.1002/hep.510300109

Cited by 215 publications

(159 citation statements)

References 22 publications

(27 reference statements)

Supporting

Mentioning

145

Contrasting

Unclassified

Order By: Relevance

“…The annual rate of non-HCC-related liver deaths in this report was 3.9% and is similar to rates of 2.4% to 4% reported in other studies. 12,13 In addition, the annual rates for HCC development in our chronic hepatitis patients was 0.9%, and in cirrhosis patients was 2.3%, both of which were similar to HCC incidence rates of 1.5% to 3.8% in Europe 14,15 and rates of 0.7% to 2.2% in Asia. 16,17 Thus, deaths of liver disease complications and HCC development, the two major causes of mortality and morbidity from hepatitis B, appear to be similar among patients from different countries.…”

Section: Discussionsupporting

confidence: 77%

Treatment recommendations for chronic hepatitis B: An evaluation of current guidelines based on a natural history study in the United States

et al. 2008

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 77%

Treatment recommendations for chronic hepatitis B: An evaluation of current guidelines based on a natural history study in the United States

et al. 2008

View full text Add to dashboard Cite

“…Such a survival rate was observed in a patient population with 2 baseline factors, old age (mean of 52 years), and frequent (Ͼ30%) presence of cirrhosis, which have been repeatedly shown to be strongly associated with development of liver-related complications and poor survival. 26,28 These data may reflect the results of long-term antiviral therapy in attentive clinical practice, because we included patients from 4 liver centers treated with similar therapeutic strategies, but not according to a strict therapeutic protocol. The efficacy of lamivudine was similar to what has been previously reported in other studies from Greece 16,17 and Italy 29 with approximately one third of patients remaining in remission at 4 years of therapy.…”

Section: Discussionmentioning

confidence: 99%

Outcome of hepatitis B e antigen-negative chronic hepatitis B on long-term nucleos(t)ide analog therapy starting with lamivudine

et al. 2005

View full text Add to dashboard Cite

We determined the clinical outcome of hepatitis e antigen (HBeAg)-negative chronic hepatitis B patients treated with long-term nucleos(t)ide analog therapy starting with lamivudine. We evaluated 201 such patients treated for 3.8 ؎ 1.4 years and 2 historical similar cohorts: 1 treated with interferon-alfa (n ‫؍‬ 209) and 1 untreated (n ‫؍‬ 195). Virological or biochemical remission rate at 48 months under lamivudine was 34% or 36%, respectively, whereas adefovir was administered in 79 patients with virological-biochemical breakthroughs or no response. Of the lamivudinetreated patients, 4 died, 1 underwent a transplantation, and another 8 developed major events, all having advanced fibrosis at baseline and all but 1 having experienced breakthroughs or no response. At 5 years, survival was 96%, and major event-free survival was 93%. The major event-free survival was significantly better in patients with than in those without virological remission under lamivudine. At the end of follow-up, both survival and major event-free survival were independently associated with type of and response to treatment, being significantly better in patients under long-term antiviral therapy or interferon sustained responders than in interferon non-sustained responders or untreated cases (5-year survival: 96% or 98% vs. 88% or 90%, respectively). In conclusion, in HBeAg-negative chronic hepatitis B, long-term nucleos(t)ide analog therapy starting with lamivudine significantly improves survival and reduces the risk of major complications, compared with interferon non-sustained responders or untreated patients. In such patients with advanced fibrosis, close follow-up for lamivudine resistance and prompt onset of additional antiviral therapy is required or the ab initio use of agent(s) with low resistance rates should be considered. (HEPATOLOGY 2005;42:121-129.) H epatitis e antigen (HBeAg)-negative chronic hepatitis B (CHB) represents a rather late phase in the course of chronic hepatitis B virus (HBV) infection 1,2 usually associated with replication of HBV variants that are unable to produce HBeAg because of mutations either at the precore or basic core promoter region of the viral genome. 2,3 HBeAg-negative CHB is a potentially severe and progressive form of chronic liver disease with rare spontaneous remissions, frequent progression to cirrhosis, and increased risk of hepatocellular carcinoma (HCC). [4][5][6][7] The management of CHB has improved over the last years with the addition of lamivudine and more recently adefovir dipivoxil (ADV), but it is still suboptimal in achieving sustained off-therapy responses. [8][9][10][11] In particular in HBeAg-negative CHB, interferon-alfa (IFN␣), the first available effective therapeutic option in CHB, is the agent offering the higher chances for sustained-off therapy response ranging between 18% and 30%. 10-13 Conversely, both lamivudine and ADV, 2 oral, safe, and well-

show abstract

“…[48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64] Most patients with HBeAg-negative chronic hepatitis B harbor HBV variants in the precore or core promoter region. [49][50][51][52][53][54][55][56]59,[62][63][64][65][66][67] The most common precore mutation, G 1896 A, creates a premature stop codon in the precore region thus abolishing production of HBeAg.…”

Section: Terminology and Natural History Of Chronic Hbv Infectionmentioning

confidence: 99%

“…43 In carriers referred to clinical centers, the reported incidence of cirrhosis is as high as 2% to 3% per year possibly because of underlying chronic hepatitis. 61,[72][73][74] Prognostic factors for the development of cirrhosis include HBeAg positivity, older age, and elevated ALT levels. 72,73,75 For patients with compensated cirrhosis, the survival is 84% at 5 years and 68% at 10 years.…”

Section: Terminology and Natural History Of Chronic Hbv Infectionmentioning

confidence: 99%

Chronic hepatitis B

2001

View full text Add to dashboard Cite

PREAMBLEThese guidelines have been written to assist physicians and other health care providers in the recognition, diagnosis, and management of patients chronically infected with the hepatitis B virus (HBV). They are intended to suggest preferable approaches to the clinical management of chronic hepatitis B. The recommendations are flexible and are not intended as the only acceptable approach to management and treatment. As the appropriate course of treatment will vary in light of the relevant facts and circumstances surrounding each individual patient with chronic hepatitis B, guidelines are not intended to define the applicable standard of medical care and may be updated periodically as new information becomes available.These guidelines were developed under the auspices of, and approved by, the Practice Guidelines Committee of the American Association for the Study of Liver Diseases. They should be taken as guidelines and not "standards of care." Data used to support the recommendations made were obtained by a literature search of peer-reviewed articles concerning the natural history, diagnosis, and treatment of chronic hepatitis B. In addition, the proceedings of a recent National Institutes of Health workshop on the "Management of Hepatitis B" were considered in the development of these guidelines. 1 The strength of each recommendation is categorized based on the quality of evidence in the literature according to the rating system indicated in Table 1. 2

show abstract

The long-term course of chronic hepatitis B

Cited by 215 publications

References 22 publications

Treatment recommendations for chronic hepatitis B: An evaluation of current guidelines based on a natural history study in the United States

Treatment recommendations for chronic hepatitis B: An evaluation of current guidelines based on a natural history study in the United States

Outcome of hepatitis B e antigen-negative chronic hepatitis B on long-term nucleos(t)ide analog therapy starting with lamivudine

Chronic hepatitis B

Contact Info

Product

Resources

About