scholarly journals HBeAg-positive patients with HBsAg  < 100 IU/mL and negative HBV RNA have lower risk of virological relapse after nucleos(t)ide analogues cessation

2021 ◽  
Author(s):  
Yandi Xie ◽  
Minghui Li ◽  
Xiaojuan Ou ◽  
Sujun Zheng ◽  
Yinjie Gao ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Operating Characteristic ◽  
Clinical Relapse ◽  
Stopping Criteria ◽  
Related Factors ◽  
Virological Relapse ◽  
End Of Treatment ◽  
B Virus ◽  
Multicenter Prospective Cohort Study ◽  
Multicenter Prospective Cohort

Abstract Background Nucleos(t)ide analogues (NAs) cessation is not widely practiced and remains a controversial, but highly relevant subject in patients infected with hepatitis B virus (HBV). We aimed to explore the related factors for safe NAs cessation. Methods This is a multicenter prospective cohort study. Overall, 139 initially HBV e antigen (HBeAg)-positive patients meeting the stopping criteria were included in 12 hospitals in China. Enrolled patients ceased NAs and were followed up every 3 months for 24 months or until clinical relapse (CR). Results The 24 month cumulative rates of virological relapse (VR), CR, HBeAg reversion and HBV surface antigen (HBsAg) loss were 50.4, 24.5, 11.5 and 9.4%, respectively. Patients with end of treatment (EOT) HBsAg  < 100 IU/mL plus negative HBV RNA had the lowest 24 month cumulative VR rate (5 vs 58%, p < 0.001). EOT HBsAg  ≥ 2 log10 IU/mL [odds ratio (OR) = 6.686, p = 0.006], EOT positive HBV RNA (OR = 3.453, p = 0.008) and EOT hepatitis B core-related antigen (HBcrAg)  ≥ 4log U/mL (OR = 3.702, p = 0.002) were found to independently predict the risk of VR. To predict VR, the area under the receiver-operating characteristic (AUROC) value of the EOT HBsAg  < 100 IU/mL plus EOT HBV RNA negative was 0.698 (p < 0.001), which was higher than other parameters alone or combinations. Conclusions NAs cessation is suitable only for a small and selected patients. An EOT HBsAg  < 100 IU/mL and EOT negative HBV RNA identified a patient with low risk of off-treatment VR.

Combining Hepatitis B Virus RNA and Hepatitis B Core–Related Antigen: Guidance for Safely Stopping Nucleos(t)ide Analogues in Hepatitis B e Antigen–Positive Patients With Chronic Hepatitis B

2020 ◽  
Vol 222 (4) ◽  
pp. 611-618 ◽  
Author(s):  
Rong Fan ◽  
Jie Peng ◽  
Qing Xie ◽  
Deming Tan ◽  
Min Xu ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Risk Group ◽  
Clinical Relapse ◽  
Treatment Cessation ◽  
Hepatitis B E Antigen ◽  
Virus Rna ◽  
B Virus

Abstract Background Safe nucleos(t)ide analogue discontinuation in chronic hepatitis B (CHB) is an unmet need. We aimed to investigate whether combining hepatitis B virus (HBV) RNA and hepatitis B core–related antigen (HBcrAg) could perform satisfactorily in predicting off-treatment outcomes. Methods The evaluation cohort included 127 hepatitis B e antigen (HBeAg)–positive patients from a multicenter prospective trial who stopped telbivudine-based therapy after achieving HBeAg seroconversion and HBV DNA &lt; 50 IU/mL for &gt; 48 weeks. As validation, 59 patients treated with entecavir or tenofovir before discontinuation were analyzed. Results At the end of treatment (EOT), HBV RNA and HBcrAg were significant independent predictors of the clinical relapse risk. In the evaluation cohort, no clinical relapse occurred among patients with negative HBV RNA and HBcrAg &lt; 4 log10 U/mL at EOT (low-risk group), whereas 46.8% patients with positive HBV RNA and HBcrAg ≥ 4 log10 U/mL (high-risk group) experienced clinical relapse during 4-year posttreatment follow-up (P &lt; .001); the corresponding incidences in the validation cohort were 0% and 69.4% (P &lt; .001), respectively. More patients in the low-risk group achieved HBsAg loss than the other patients after treatment cessation (16.1% vs 1.3%, P = .002). Conclusions Combining HBV RNA and HBcrAg performed satisfactorily in predicting clinical relapse and HBsAg loss after treatment cessation in HBeAg-positive patients with CHB. The combination of hepatitis B virus RNA and hepatitis B core–related antigen performed satisfactorily in predicting clinical relapse and hepatitis B surface antigen loss after stopping nucleos(t)ide analogue treatment among noncirrhotic hepatitis B e antigen–positive patients with chronic hepatitis B and could be used to guide safe discontinuation.

Evaluation of Serum GDF15, AFP, and PIVKA-II as Diagnostic Markers for HBV-Associated Hepatocellular Carcinoma

2020 ◽  
Author(s):  
Juanjuan Chen ◽  
Dongling Tang ◽  
Chu Xu ◽  
Zhili Niu ◽  
Huan Li ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis B ◽  
Diagnostic Accuracy ◽  
Roc Curve ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Serum Levels ◽  
Diagnostic Value ◽  
Serum Marker ◽  
B Virus

Abstract Objective To evaluate the potential diagnostic value of growth differentiation factor 15 (GDF15) alone and its combination with protein induced by vitamin K absence-II (PIVKA-II) and alpha-fetoprotein (AFP) for hepatitis B virus (HBV)-associated hepatocellular carcinoma (HCC). Methods Serum levels of GDF15, PIVKA-II, and AFP were measured in 110 patients with HBV-associated HCC, 70 patients with HBV-related liver cirrhosis (LC), 70 patients with chronic hepatitis B (CHB), and 110 healthy patients. Results Serum GDF15 was positively related to the levels of PIVKA-II and AFP in patients with HCC (r = 0.352 and r = 0.378; all P &lt;.0001). When the receiver operating characteristic (ROC) curve was plotted for patients with HCC vs all control patients, serum GDF15 had diagnostic parameters of an area under the curve (AUC) of 0.693, a sensitivity of 67.30%, and a specificity of 66.70%, which were lower than parameters for PIVKA-II and AFP (all P &lt;.0001). When the ROC curve was plotted for patients with HCC vs patients with LC, the combination of GDF15 and PIVKA-II had the highest diagnostic accuracy of AUC and specificity as compared with other combinations (all P &lt;.0001). Conclusion We found that GDF15 is a potent serum marker for the detection of HBV-associated HCC and that PIVKA-II combined with GDF15 can improve diagnostic accuracy for HBV-associated HCC.

scholarly journals Comparison of Two Hepatitis B Vaccination Strategies Targeting Vertical Transmission: A 10-Year Japanese Multicenter Prospective Cohort Study

Vaccines ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 58
Author(s):  
Koji Nishimura ◽  
Keiji Yamana ◽  
Sachiyo Fukushima ◽  
Kazumichi Fujioka ◽  
Hiroshi Miyabayashi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hepatitis B ◽  
Confidence Interval ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Virus Transmission ◽  
Vaccination Strategies ◽  
Multicenter Prospective Cohort Study ◽  
Multicenter Prospective Cohort ◽  
Immunogenic Response

In 1985, a hepatitis B (HB) vaccination strategy against vertical HB virus transmission was introduced in Japan that recommended vaccination of infants at two, three, and five months of age (delayed strategy). This schedule was revised in 2013, recommending to vaccinate at birth and at 1 and 6 months of age (non-delayed strategy). We aimed to compare the vertical HB virus transmission rates and immunogenic responses between these two vaccination strategies. This Japanese multicenter prospective cohort study included 222 infants born between 2008 and 2017 to serum hepatitis B surface (HBs) antigen (HBsAg)-positive mothers. During the study period, 136 and 86 infants received delayed and non-delayed strategies, respectively. A positive vertical HB virus transmission was defined as a positive serum HBsAg status. Seropositive immunogenic response was defined as a serum anti-HBs titer of ≥10 mIU/mL. Post-vaccination serum HBsAg positivity rates did not differ significantly between the delayed (0/136 [0.0%, 95% confidence interval, 0.0–2.7%]) and non-delayed (2/86 [2.3%, 95% confidence interval, 0.3–8.1%]) strategy groups. Seropositive immunogenic response rates were 100.0% (136/136) and 97.7% (84/86), respectively. Although this study was under-powered to detect a statistically significant result, no vertical HB virus transmission was observed in the delayed strategy.

Hepatitis B virus infection and related factors in hemodialysis patients in China – systematic review and meta-analysis

Renal Failure ◽  
2010 ◽  
Vol 32 (10) ◽  
pp. 1255-1264 ◽  
Author(s):  
Cuiyu Wang ◽  
Jinghua Sun ◽  
Bei Zhu ◽  
Steven Larsen ◽  
Rongbin Yu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hepatitis B Virus ◽  
Virus Infection ◽  
Hepatitis B ◽  
Meta Analysis ◽  
Hemodialysis Patients ◽  
Hepatitis B Virus Infection ◽  
Related Factors ◽  
B Virus

scholarly journals Quantification and epigenetic evaluation of the residual pool of hepatitis B covalently closed circular DNA in long-term nucleoside analogue-treated patients

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Fanny Lebossé ◽  
Aurore Inchauspé ◽  
Maëlle Locatelli ◽  
Clothilde Miaglia ◽  
Audrey Diederichs ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Rolling Circle Amplification ◽  
Added Value ◽  
Treatment Withdrawal ◽  
Histone Tails ◽  
Rolling Circle ◽  
Virological Relapse ◽  
B Virus ◽  
Liver Biopsies

AbstractHepatitis B virus (HBV) covalently closed circular (ccc)DNA is the key genomic form responsible for viral persistence and virological relapse after treatment withdrawal. The assessment of residual intrahepatic cccDNA levels and activity after long-term nucleos(t)ide analogues therapy still represents a technical challenge. Quantitative (q)PCR, rolling circle amplification (RCA) and droplet digital (dd)PCR assays were used to quantify residual intrahepatic cccDNA in liver biopsies from 56 chronically HBV infected patients after 3 to 5 years of telbivudine treatment. Activity of residual cccDNA was evaluated by quantifying 3.5 kB HBV RNA (preC/pgRNA) and by assessing cccDNA-associated histone tails post-transcriptional modifications (PTMs) by micro-chromatin immunoprecipitation. Long-term telbivudine treatment resulted in serum HBV DNA suppression, with most of the patients reaching undetectable levels. Despite 38 out of 56 patients had undetectable cccDNA when assessed by qPCR, RCA and ddPCR assays detected cccDNA in all-but-one negative samples. Low preC/pgRNA level in telbivudine-treated samples was associated with enrichment for cccDNA histone PTMs related to repressed transcription. No difference in cccDNA levels was found according to serum viral markers evolution. This panel of cccDNA evaluation techniques should provide an added value for the new proof-of-concept clinical trials aiming at a functional cure of chronic hepatitis B.

LIVER FIBROSIS RESPONSE TO ENTECAVIR TREATMENT IN PATIENTS WITH HBV-RELATED COMPENSATED CIRRHOSIS

2018 ◽  
Vol 8 (6) ◽  
pp. 203-209
Author(s):  
Trung Doan Hieu ◽  
Chuong Tran Xuan
Keyword(s):  
Hepatitis B Virus ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Acoustic Radiation ◽  
Term Treatment ◽  
Related Factors ◽  
Compensated Cirrhosis ◽  
Long Term Treatment ◽  
B Virus

Background: Evaluating improvement of liver fibrosis response after anti HBV therapy in our country until now is very limited, especially in patients with cirrhosis. This study aimed at assessing the respone in liver fibrosis determined by ARFI and its related factors for patients with compensated HBV-related cirrhosis undergoing entecavir therapy. Subjects and methods: 60 patients with compensated HBV-related cirrhosis were enrolled at Da Nang Hospital from 06/2016 to 06/2018. All received entecavir 0,5mg a day 2 hours after breakfast and followed in 18 months. Liver fibrosis is measured by Acoustic Radiation Forced Imaging (ARFI). Results: Entecavir treatment may result in improvement of liver fibrosis in 20% after 12 months and 26.67% after 18 months in patients with compensated hepatitis B virus-related cirrhosis. The improvement in fibrosis levels was significant after at least 12 months of treatment. Factors associated with improvement of fibrosis response in this study included AST, ALT, AFP are high, HBeAg (+), low prothrombin time at baseline, and indetectable HBV DNA after 6 months of treatment. Conclusion: Entecavir treatment may help to improve liver fibrosis in patients with hepatitis B virus-related compensated cirrhosis, but long-term treatment is needed. Key words: Entecavir, HBV cirrhosis, liver fibrosis, ARFI

165 THE PROGNOSIS AND ITS RELATED FACTORS IN PATIENTS WITH HEPATITIS B VIRUS-RELATED LIVER CIRRHOSIS IN THE ANTIVIRAL ERA

2011 ◽  
Vol 54 ◽  
pp. S71
Author(s):  
C.H. Kim ◽  
Y.S. Seo ◽  
J.H. Kim ◽  
H.J. Yim ◽  
J.E. Yeon ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Related Factors ◽  
B Virus
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