On-treatment ALT flares are associated with HBsAg loss in genotype A chronic hepatitis B-infected patients treated with nucleotide analogue therapy

Objective:- Hepatitis B is noteworthy medical issues that may include the late continuation of liver cirrhosis and hepatocellular carcinoma. The present study aimed for the detection and diffrentiation of Hepatitis B virus HBsAg inactive non-replicative carriers, HBeAg-positive inactive replicative carriers, active carriers & HBeAg-negative chronic hepatitis B by Real Time PCR and their genotyping Methods: This research conducted on 245 positive for HBsAg, 118 (48.16 %) were male and 127 (51.84%) were female patients, which was performed in central research station labortory of Microbiology at netaji subhash Chandra Bose subharti Medical College and Hospital, Meerut Between march 2016 to November 2017 The sera were separated and screened for HBsAg by ELISA kit. Positive samples for HBsAg were tested for HBeAg ELISA kit and DNA Viral load then sequenced for genotying Results:. Of the 245 HBsAg Positive case 55 (1.12%) were HBeAg positive. In 16 PCR positive and HBV genotyping, In HBsAg inactive Non-Replicative 37.5% (n=6) genotype-B and 6.25% (n=1) genotype-A, In HBeAg inactive Replicative 12.5% (n=2) genotype-B and 12.5% (n=2) genotype-A and In HBeAg Active Chronic Hepatitis B 18.75% (n=3) genotype-B and 12.5% (n=2) genotype-A were detected Conclusions: Management strategy, using HBsAg, HBeAg and HBV DNA viral load, seems adequate for the confirmation and diffrentiation of Hepatitis B virus inactive, active carriers & HBeAg-negative chronic hepatitis B patients and genotype B was more prevalent in comparission to genotype A. Distribution of carriers & genotypes, help physicians to prescribe proper antiviral/interferon therapy according to current genotyping pattern in this region Keywords: Hepatitis B virus, Carrier State, HBsAg, HBeAg, RT-PCR

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O.048 Treatment of chronic hepatitis B with the combination of pegylated interferon with a nucleoside/nucleotide analogue

Journal of Clinical Virology ◽

10.1016/s1386-6532(06)80056-9 ◽

2006 ◽

Vol 36 ◽

pp. S15

Author(s):

P. Marcellin

Keyword(s):

Chronic Hepatitis ◽

Hepatitis B ◽

Chronic Hepatitis B ◽

Pegylated Interferon ◽

Nucleotide Analogue

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Assessing The Consequences Of Sustained Off-Therapy Hbsag Loss In Health Economic Models Of Chronic Hepatitis B; A Systematic Literature Review

Value in Health ◽

10.1016/j.jval.2016.09.386 ◽

2016 ◽

Vol 19 (7) ◽

pp. A413

Author(s):

M Hashim ◽

K Cerri ◽

U Sbarigia ◽

B Heeg

Keyword(s):

Health Economic ◽

Chronic Hepatitis ◽

Hepatitis B ◽

Literature Review ◽

Chronic Hepatitis B ◽

Systematic Literature Review ◽

Economic Models ◽

Hbsag Loss

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Correction: DARING-B: discontinuation of effective entecavir or tenofovir disoproxil fumarate long‑term therapy before HBsAg loss in non-cirrhotic HBeAg‑negative chronic hepatitis B

Antiviral Therapy ◽

10.3851/imp3261 ◽

2018 ◽

Vol 23 (8) ◽

pp. 711

Author(s):

George V Papatheodoridis ◽

Eirini I Rigopoulou ◽

Margarita Papatheodoridi ◽

Kalliopi Zachou ◽

Vassilios Xourafas ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis B ◽

Chronic Hepatitis B ◽

Tenofovir Disoproxil Fumarate ◽

Term Therapy ◽

Hbsag Loss ◽

Long Term Therapy ◽

Negative Chronic Hepatitis

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The Yin and the Yang of Treatment for Chronic Hepatitis B—When to Start, When to Stop Nucleos(t)ide Analogue Therapy

Viruses ◽

10.3390/v12090934 ◽

2020 ◽

Vol 12 (9) ◽

pp. 934 ◽

Cited By ~ 1

Author(s):

Samuel Hall ◽

Jessica Howell ◽

Kumar Visvanathan ◽

Alexander Thompson

Keyword(s):

Chronic Hepatitis ◽

Hepatitis B ◽

Chronic Hepatitis B ◽

Antiviral Agents ◽

Standard Of Care ◽

Current Standard ◽

Hbsag Loss ◽

Personalised Treatment ◽

Treat All

Over 257 million individuals worldwide are chronically infected with the Hepatitis B Virus (HBV). Nucleos(t)ide analogues (NAs) are the first-line treatment option for most patients. Entecavir (ETV) and tenofovir disoproxil fumarate (TDF) are both potent, safe antiviral agents, have a high barrier to resistance, and are now off patent. They effectively suppress HBV replication to reduce the risk of cirrhosis, liver failure, and hepatocellular carcinoma (HCC). Treatment is continued long-term in most patients, as NA therapy rarely induces HBsAg loss or functional cure. Two diverging paradigms in the treatment of chronic hepatitis B have recently emerged. First, the public health focussed “treat-all” strategy, advocating for early and lifelong antiviral therapy to minimise the risk of HCC as well as the risk of HBV transmission. In LMICs, this strategy may be cost saving compared to monitoring off treatment. Second, the concept of “stopping” NA therapy in patients with HBeAg-negative disease after long-term viral suppression, a personalised treatment strategy aiming for long-term immune control and even HBsAg loss off treatment. In this manuscript, we will briefly review the current standard of care approach to the management of hepatitis B, before discussing emerging evidence to support both the “treat-all” strategy, as well as the “stop” strategy, and how they may both have a role in the management of patients with chronic hepatitis B.

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Caucasian Ethnicity, but Not Treatment Cessation is Associated with HBsAg Loss Following Nucleos(t)ide Analogue-Induced HBeAg Seroconversion

Viruses ◽

10.3390/v11080687 ◽

2019 ◽

Vol 11 (8) ◽

pp. 687 ◽

Cited By ~ 3

Author(s):

Hees ◽

Chi ◽

Hansen ◽

Bourgeois ◽

Vlierberghe ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis B ◽

Chronic Hepatitis B ◽

Treatment Duration ◽

Hbeag Seroconversion ◽

Hazard Ratio ◽

Treatment Cessation ◽

Consolidation Treatment ◽

Hbsag Loss ◽

Loss Rates

It is well appreciated that ethnicity influences the natural history and immune responses during a chronic hepatitis B infection. In this study, we explore the effect of ethnicity and treatment cessation on Hepatitis B surface Antigen (HBsAg) seroclearance in patients with Nucleos(t)ide Analogue (NA)-induced Hepatitis B e Antigen (HBeAg) seroconversion. We performed a multi-ethnic, multicentric observational cohort study. The analyzed cohort consisted of 178 mono-infected, predominantly male (75.3%) chronic hepatitis B patients of mixed ethnicity (44.4% Asians, 48.9% Caucasians) with nucleos(t)ide analogue-induced HBeAg seroconversion. Treatment was withdrawn in 105 patients and continued in 73, leading to HBsAg loss in 14 patients off- and 16 patients on-treatment, respectively. Overall, HBsAg loss rates were not affected by treatment cessation (hazard ratio 1.45, p = 0.372), regardless of consolidation treatment duration. Caucasian ethnicity was associated with an increased chance of HBsAg loss (hazard ratio 6.70, p = 0.001), but hepatitis B virus genotype was not (p = 0.812). In conclusion, ethnicity is the most important determinant for HBsAg loss after NA-induced HBeAg seroconversion, with up to six-fold higher HBsAg loss rates in Caucasians compared to Asians, irrespective of treatment cessation and consolidation treatment duration.

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