50 Durability of response and occurrence of late response to peginterferon alpha-2a (40KD) [PEGASYS] one year post-treatment in patients with HBeAg-positive chronic hepatitis B

Lau, G.K.K.; Piratvisuth, Teerha; Luo, K.X.; Marcellin, Patrick; Thongsawat, Satawat; Cooksley, Graham; Gane, E.; Fried, M; Popescu, M.; Wu, Jia Sen

doi:10.1016/s0168-8278(06)80051-6

Cited by 29 publications

(28 citation statements)

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“…PegIFN-a therapy results in HBeAg seroconversion rates of up to 32% and 48%, respectively, when assessed at weeks 24 and 48 post-treatment [43][44][45][46] and sustained after cessation of therapy in the majority (80-90%) of HBeAgpositive patients [47]. Baseline HBV and ALT levels are predictive factors for HBeAg seroconversion [47].…”

Section: Treatment-induced Hbeag Seroconversion and Disease Progressionmentioning

confidence: 99%

HBeAg seroconversion as an important end point in the treatment of chronic hepatitis B

2009

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During the natural history of chronic hepatitis B virus (HBV) infection, the loss of serum hepatitis B e antigen (HBeAg) and the development of anti-HBe antibodies (HBeAg seroconversion) mark a transition from the immune-active phase of disease to the inactive carrier state. This review examines the evidence from natural history and cohort studies on the relationship between HBeAg seroconversion and disease progression. The role of HBeAg seroconversion as an important milestone in the management of HBeAg-positive patients with chronic hepatitis B (CHB), as well as the advantages and disadvantages of administering a finite course of therapy for HBeAg-positive CHB, is also discussed. The evidence from natural history and cohort studies indicates that spontaneous or treatment-induced HBeAg seroconversion is associated with lower rates of disease progression to cirrhosis and hepatocellular carcinoma, a potential of hepatitis B surface antigen seroconversion, and improved survival rates. Updated guidelines developed by major liver associations recommend stopping oral therapy for HBeAgpositive patients who achieve sustained HBeAg seroconversion with polymerase chain reaction-undetectable HBV-DNA on two separate occasions for 6 or more months apart, taking into consideration the individual's clinical and virologic response to therapy, as well as the severity of liver disease. Thus, early induction of HBeAg seroconversion with interferon-based therapy or oral nucleos(t)ide analogues has important clinical and socioeconomic implications for the management of CHB.

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Section: Treatment-induced Hbeag Seroconversion and Disease Progressionmentioning

confidence: 99%

HBeAg seroconversion as an important end point in the treatment of chronic hepatitis B

2009

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“…In a study of Peg IFN-a-2b involving mainly Caucasian patients (79%), a 52-week course (100 lg once weekly for 32 weeks followed by 50 lg weekly for 20 weeks) gave a 26-week sustained HBeAg seroconversion in 29% of patients and HBsAg clearance in 7% of patients [44]. The long-term follow-up post-Peg IFN-a-2a therapy showed delayed HBeAg seroconversion in 14% of the initial non-responders and durability of HBeAg seroconversion in 86% of initial responders at 1 year after the end of treatment [45]. Among Asian patients who achieved a sustained HBeAg seroconversion at 12 months post-treatment, 69% had HBV DNA levels \10,000 copies/ml and 38% had HBV DNA levels \400 copies/ ml [43].…”

Section: Pegylated Interferon Alfa (Peg Ifn-a)mentioning

confidence: 98%

“…Studies of combination therapy of IFN-a or Peg IFN-a and lamivudine compared with IFN-a or Peg IFN-a alone or lamivudine alone in HBeAg-positive and HBeAg-negative chronic hepatitis B patients have found that the combination therapy had greater on-treatment viral suppression and a higher rate of sustained response than lamivudine alone, but there was no difference in sustained off-treatment response when compared to IFN-a or Peg IFN-a alone [42][43][44][45][46][47][48][49][50][51][52].…”

Section: Combination Therapymentioning

confidence: 99%

“…The most frequently reported side effects are flu-like symptoms, headache, fatigue, myalgia, alopecia, and local reaction at the injection site [43,45,48]. IFN-a and Peg IFN-a have myelosuppressive effects but neutropenia \1,000/mm 3 and thrombocytopenia \50,0000/mm 3 are uncommon unless patients have cirrhosis or low cell counts prior to treatment.…”

Section: Side Effects Of Ifn and Peg Ifn-amentioning

confidence: 99%

“…Although IFN and Peg IFN have many side effects, they are well tolerated. Premature discontinuation due to patient's intolerability has been reported in 2-8% of patients treated with Peg IFN-a [43,45,48,65].…”

Section: Side Effects Of Ifn and Peg Ifn-amentioning

confidence: 99%

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Reviews for APASL guidelines: immunomodulator therapy of chronic hepatitis B

Piratvisuth

2008

Hepatol Int

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The primary aim of immunomodulator therapy is to help the natural human immune system to mount a defense against hepatitis B virus. IFN-a has been used for the treatment of HBeAg-positive and HBeAg-negative chronic hepatitis B for over two decades and has been shown to be effective in suppressing HBV replication and in inducing serological response leading to long-term clinical benefits. IFN-a has been used in patients with wellcompensated cirrhosis with comparable or better response to that in non-cirrhotic patients. IFN-a therapy in patients with cirrhosis has a similar side effect profile as in those without cirrhosis. However, IFN-a is contraindicated in patients with overt or decompensated cirrhosis. Pegylated IFN-a has been shown to be effective in treatment of chronic hepatitis B with sustained response rate in about one-third of the treated patients. Peg IFN-a treatment in non-responders to lamivudine or adefovir dipivoxil showed similar response rate to that seen in naïve patients. Thymosin a 1 is effective in treatment of HBeAg-positive and HBeAg-negative chronic hepatitis B with a significantly increasing virological response over time after therapy.

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Chronic hepatitis B: a global health problem requiring coherent worldwide treatment strategies

2007

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Chronic hepatitis B virus infection, a major cause of end-stage liver disease and hepatocellular carcinoma, is a worldwide health concern. While the past two decades have brought major advances in the availability of treatments to help delay or prevent these outcomes, treatment of chronic hepatitis B remains a serious challenge, not least due to the ability of the virus to remain in hepatocyte nuclei as a source of potential reactivation-hence the term chronic hepatitis B infection. This article reviews the current treatments available and suggests a framework for a rational approach to managing the disease.

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50 Durability of response and occurrence of late response to peginterferon alpha-2a (40KD) [PEGASYS] one year post-treatment in patients with HBeAg-positive chronic hepatitis B

Cited by 29 publications

References 0 publications

HBeAg seroconversion as an important end point in the treatment of chronic hepatitis B

HBeAg seroconversion as an important end point in the treatment of chronic hepatitis B

Reviews for APASL guidelines: immunomodulator therapy of chronic hepatitis B

Chronic hepatitis B: a global health problem requiring coherent worldwide treatment strategies

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