Predictors of relapse in chronic hepatitis B after discontinuation of anti-viral therapy.
Y. Liang,Jian-ning Jiang,Ming-hua Su,Zhengtao Liu,W. Guo,X. Huang,Rong Xie,S. Ge,J. Hu,Z. Jiang,M. Zhu,V. W.-S. Wong,Hung Chan +12 more
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Aliment Pharmacol Ther 2011; 34: 344–352Abstract:
Aliment Pharmacol Ther 2011; 34: 344–352
Summary
Background Optimal duration of anti-viral therapy in chronic hepatitis B virus (HBV) infection remains unclear.
Aim To investigate factors that could predict relapse after stopping anti-viral agents.
Methods Chronic hepatitis B patients who were treated with anti-viral agents (lamivudine, adefovir, entecavir) and have stopped the treatment were recruited. Anti-viral agents were stopped according to the recommendations of the Asian Pacific Association for the Study of the Liver. Virological relapse was defined as an increase in serum HBV DNA to >1000 copies/mL after discontinuation of treatment.
Results Eighty-four (69 treatment naive and 15 lamivudine resistant) patients were eligible for this study. Thirty-seven patients developed virological relapse at 4.3 ± 2.9 (range 1–11) months after discontinuation of therapy. The 1-year cumulative probability of virological relapse was 42% and 47% in HBeAg (hepatitis B e antigen)-positive (n = 41) and HBeAg (hepatitis B e antigen)-negative (n = 43) patients, respectively. On multivariate analysis by Cox proportional hazard model, pre-existing lamivudine resistance, delayed suppression of HBV DNA to undetectable level during anti-viral therapy and to a higher HBsAg (hepatitis B surface antigen) level at the end of treatment were associated with virological relapse. Twelve of the 15 (80%) lamivudine resistant patients developed virological relapse. Among the 11 treatment naive patients who had HBsAg ≤2 log IU/mL at the end of treatment, 1 (9%) of them had virological relapse.
Conclusions Treatment cessation among lamivudine resistant patients is associated with high risk of virological relapse. Serum HBsAg level at the end of treatment and rate of HBV DNA suppression can provide supplementary information to guide the timing of stopping anti-viral drugs.read more
Citations
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Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update.
Shiv Kumar Sarin,Manoj Kumar,George K. K. Lau,Zaigham Abbas,Henry Lik-Yuen Chan,Chien-Jen Chen,Ding-Shinn Chen,Huey-Ling Chen,Pei-Jer Chen,Rong-Nan Chien,Abdul Kadir Dokmeci,Edward Gane,J L Hou,Wasim Jafri,Jidong Jia,J. H. Kim,Ching-Lung Lai,Hon Cheung Lee,Seng Gee Lim,Chun-Jen Liu,Stephen Locarnini,M. Al Mahtab,Rosmawati Mohamed,Masao Omata,Jun Yong Park,Teerha Piratvisuth,Barjesh Chander Sharma,Jose D. Sollano,Fu-Sheng Wang,Lai Wei,Man-Fung Yuen,Shusen Zheng,Jia-Horng Kao +32 more
TL;DR: The final clinical practice guidelines and recommendations for the optimal management of chronic HBV infection are presented here, along with the relevant background information.
Journal ArticleDOI
Asian-Pacific consensus statement on the management of chronic hepatitis B: a 2012 update.
Yun Fan Liaw,Jia-Horng Kao,Teerha Piratvisuth,Henry Lik-Yuen Chan,Rong-Nan Chien,Chun-Jen Liu,Edward Gane,Stephen Locarnini,Seng Gee Lim,Kwang Hyub Han,Deepak Amarapurkar,Graham Cooksley,Wasim Jafri,Rosmawati Mohamed,Jin Lin Hou,Wan-Long Chuang,Laurentius A. Lesmana,Jose D. Sollano,Dong Jin Suh,Masao Omata +19 more
TL;DR: New HBV management guidelines include general management, indications for fibrosis assessment, time to start or stop drug therapy, choice of drug to initiate therapy, when and how to monitor the patients during and after stopping drug therapy.
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Sustained responses and loss of HBsAg in HBeAg-negative patients with chronic hepatitis B who stop long-term treatment with adefovir.
Stephanos J. Hadziyannis,Vassilios A. Sevastianos,Irene Rapti,Dimitrios Vassilopoulos,Emilia Hadziyannis +4 more
TL;DR: In HBeAg-negative patients with CHB, it is safe and effective to discontinue ADV therapy after 4 or 5 years; 55% of patients have sustained responses, and 39% of Patients lose HBsAg.
Journal ArticleDOI
Treatment cessation of entecavir in Asian patients with hepatitis B e antigen negative chronic hepatitis B: a multicentre prospective study
Wai-Kay Seto,Aric J. Hui,Vincent Wai-Sun Wong,Grace Lai-Hung Wong,Kevin Liu,Ching-Lung Lai,Man-Fung Yuen,Henry Lik-Yuen Chan +7 more
TL;DR: Entecavir cessation in Asian HBeAg negative CHB resulted in high rates of virologic relapse, suggesting nucleos(t)ide analogue therapy should be continued indefinitely until the recognised treatment endpoint of HBsAg seroclearance.
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The role of hepatitis B surface antigen quantification in predicting HBsAg loss and HBV relapse after discontinuation of lamivudine treatment.
Chien-Hung Chen,Sheng-Nan Lu,Chao-Hung Hung,Jing-Houng Wang,Tsung-Hui Hu,Chi-Sin Changchien,Chuan-Mo Lee +6 more
TL;DR: Serum HBsAg level at the end of treatment is a useful predictor to guide the timing of stopping lamivudine treatment in chronic hepatitis B patients.
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