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dc.contributorVall d'Hebron Barcelona Hospital Campus
dc.contributor.authorSonneveld, Milan
dc.contributor.authorChiu, Shao-Ming
dc.contributor.authorBrakenhoff, Sylvia
dc.contributor.authorKaewdech, Apichat
dc.contributor.authorSeto, Wai-Kay
dc.contributor.authorButi Ferret, Maria
dc.contributor.authorPark, Jun Yong
dc.date.accessioned2023-08-17T11:16:15Z
dc.date.available2023-08-17T11:16:15Z
dc.date.issued2023-08
dc.identifier.citationSonneveld MJ, Chiu SM, Park JY, Brakenhoff SM, Kaewdech A, Seto WK, et al. Lower pretreatment HBV DNA levels are associated with better off-treatment outcomes after nucleo(s)tide analogue withdrawal in patients with HBeAg-neegative chronic hepatitis B: A multicentre cohort study. JHEP Reports. 2023 Aug;5(8):100790.
dc.identifier.issn2589-5559
dc.identifier.urihttps://hdl.handle.net/11351/10092
dc.descriptionEntecavir; HBV DNA; Tenofovir
dc.description.abstractBackground & Aims Pretreatment predictors of finite nucleo(s)tide analogue (NUC) therapy remain elusive. We studied the association between pretreatment HBV DNA levels and outcomes after therapy cessation. Methods Patients with chronic hepatitis B who were HBeAg negative at the start of NUC treatment were enrolled from sites in Asia and Europe. We studied the association between pretreatment HBV DNA levels and (1) clinical relapse (defined as HBV DNA >2,000 IU/ml + alanine aminotransferase >2 × the upper limit of normal or retreatment) and (2) HBsAg loss after NUC withdrawal. Results We enrolled 757 patients, 88% Asian, 57% treated with entecavir, with a median duration of treatment of 159 (IQR 156–262) weeks. Mean pretreatment HBV DNA levels were 5.70 (SD 1.5) log IU/ml and were low (<20,000 IU/ml) in 150 (20%) and high (>20,000 IU/ml) in 607 (80%). The cumulative risk of clinical relapse at 144 weeks after therapy cessation was 22% among patients with pretreatment HBV DNA levels <20,000 IU/ml vs. 60% among patients with pretreatment HBV DNA levels >20,000 IU/ml, whereas the cumulative probabilities of HBsAg loss were 17.5% vs. 5% (p <0.001). In multivariable analysis, pretreatment HBV DNA levels <20,000 IU/ml were independently associated with a reduced likelihood of clinical relapse (adjusted hazard ratio 0.379, p <0.001) and with an increased chance of HBsAg loss (adjusted hazard ratio 2.872, p <0.001). Conclusions Lower pretreatment HBV DNA levels are associated with a lower risk of clinical relapse and a higher chance of HBsAg loss after cessation of NUC therapy, independent of end-of-treatment viral antigen levels. Further studies are needed to confirm these findings in non-Asian populations. Impact and Implications A subgroup of patients with chronic hepatitis B may not require retreatment after stopping antiviral therapy. In this study, comprising 757 patients with chronic hepatitis B from Europe and Asia, we found that higher viral load before initiation of treatment was a risk factor for relapse after stopping treatment. Patients with a low HBV DNA level before starting antiviral therapy had the lowest risk of relapse, and a high chance of HBsAg loss, after stopping treatment. These findings can help select patients for treatment withdrawal and guide intensity of off-treatment monitoring.
dc.language.isoeng
dc.publisherElsevier
dc.relation.ispartofseriesJHEP Reports;5(8)
dc.rightsAttribution 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourceScientia
dc.subjectHepatitis B - Tractament
dc.subjectVirus de l'hepatitis B
dc.subjectMedicaments antivírics - Ús terapèutic
dc.subjectADN
dc.subject.meshHepatitis B, Chronic
dc.subject.meshDNA, Viral
dc.subject.meshAntiviral Agents
dc.titleLower pretreatment HBV DNA levels are associated with better off-treatment outcomes after nucleo(s)tide analogue withdrawal in patients with HBeAg-neegative chronic hepatitis B: A multicentre cohort study
dc.typeinfo:eu-repo/semantics/article
dc.identifier.doi10.1016/j.jhepr.2023.100790
dc.subject.decshepatitis B crónica
dc.subject.decsADN vírico
dc.subject.decsantivíricos
dc.relation.publishversionhttps://doi.org/10.1016/j.jhepr.2023.100790
dc.type.versioninfo:eu-repo/semantics/publishedVersion
dc.audienceProfessionals
dc.contributor.organismesInstitut Català de la Salut
dc.contributor.authoraffiliation[Sonneveld MJ, Brakenhoff SM] Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands. [Chiu SM] Department of Internal Medicine, Koahsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan. [Park JY] Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea. [Kaewdech A] Faculty of Medicine, Prince of Songkla University, Hatyai, Thailand. [Seto WK] Department of Medicine, State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong. [Buti M] Unitat del Fetge, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Ciberehd del Intituto Carlos III de Barcelona, Spain
dc.identifier.pmid37484211
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess


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