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dc.contributorVall d'Hebron Barcelona Hospital Campus
dc.contributor.authorSonneveld, Milan
dc.contributor.authorChiu, Shao-Ming
dc.contributor.authorPark, Jun Yong
dc.contributor.authorBrakenhoff, Sylvia
dc.contributor.authorKaewdech, Apichat
dc.contributor.authorSeto, Wai-Kay
dc.contributor.authorButi Ferret, Maria
dc.date.accessioned2022-09-12T08:18:44Z
dc.date.available2022-09-12T08:18:44Z
dc.date.issued2022-05
dc.identifier.citationSonneveld MJ, Chiu SM, Park JY, Brakenhoff SM, Kaewdech A, Seto WK, et al. Probability of HBsAg loss after nucleo(s)tide analogue withdrawal depends on HBV genotype and viral antigen levels. J Hepatol. 2022 May;76(5):1042–50.
dc.identifier.issn1600-0641
dc.identifier.urihttp://hdl.handle.net/11351/8136
dc.descriptionHBV genotype; Viral antigen
dc.description.abstractBackground & Aims Nucleo(s)tide analogue (NUC) withdrawal may result in HBsAg clearance in a subset of patients. However, predictors of HBsAg loss after NUC withdrawal remain ill-defined. Methods We studied predictors of HBsAg loss in a global cohort of HBeAg-negative patients with undetectable HBV DNA who discontinued long-term NUC therapy. Patients requiring retreatment after treatment cessation were considered non-responders. Results We enrolled 1,216 patients (991 with genotype data); 98 (8.1%) achieved HBsAg loss. The probability of HBsAg loss was higher in non-Asian patients (adjusted hazard ratio [aHR] 8.26, p <0.001), and in patients with lower HBsAg (aHR 0.243, p <0.001) and HBV core-related antigen (HBcrAg) (aHR 0.718, p = 0.001) levels. Combining HBsAg (<10, 10-100 or >100 IU/ml) and HBcrAg (<2log vs. ≥2 log) levels improved prediction of HBsAg loss, with extremely low rates observed in patients with HBsAg >100 IU/ml with detectable HBcrAg. HBsAg loss rates also varied with HBV genotype; the highest rates were observed for genotypes A and D, and none of the patients with HBV genotype E experienced HBsAg loss (p <0.001 for the overall comparison across genotypes; p <0.001 for genotypes A/D vs. genotypes B/C). HBV genotype C was independently associated with a higher probability of HBsAg loss when compared to genotype B among Asian patients (aHR 2.494; 95% CI 1.490–4.174, p = 0.001). Conclusions The probability of HBsAg loss after NUC cessation varies according to patient ethnicity, HBV genotype and end-of-treatment viral antigen levels. Patients with low HBsAg (<100 IU/ml) and/or undetectable HBcrAg levels, particularly if non-Asian or infected with HBV genotype C, appear to be the best candidates for treatment withdrawal.
dc.language.isoeng
dc.publisherElsevier
dc.relation.ispartofseriesJournal of Hepatology;76(5)
dc.rightsAttribution 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourceScientia
dc.subjectMedicaments antivírics - Ús terapèutic
dc.subjectHepatitis B - Tractament
dc.subject.meshAntiviral Agents
dc.subject.mesh/therapeutic use
dc.subject.meshHepatitis B, Chronic
dc.titleProbability of HBsAg loss after nucleo(s)tide analogue withdrawal depends on HBV genotype and viral antigen levels
dc.typeinfo:eu-repo/semantics/article
dc.identifier.doi10.1016/j.jhep.2022.01.007
dc.subject.decsantivíricos
dc.subject.decs/uso terapéutico
dc.subject.decshepatitis B crónica
dc.relation.publishversionhttps://doi.org/10.1016/j.jhep.2022.01.007
dc.type.versioninfo:eu-repo/semantics/publishedVersion
dc.audienceProfessionals
dc.contributor.organismesInstitut Català de la Salut
dc.contributor.authoraffiliation[Sonneveld MJ, Brakenhoff SM] Departments 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] 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, Servei de Medicina Interna, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Ciberehd del Intituto Carlos III de Barcelona, Spain
dc.identifier.pmid35092743
dc.identifier.wos000823493800007
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess


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