Clinical outcomes after spontaneous and nucleos(t)ide analogue‐treated <scp>HB</scp>sAg seroclearance in chronic <scp>HBV</scp> infection

Chen, Y. C.; Jeng, Wen–Juei; Chien, Rong Nan; Chu, Chia–Ming; Liaw, Yun–Fan

doi:10.1111/apt.13630

Cited by 40 publications

(43 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is the first study with long-term follow-up to compare the difference in the clinical outcomes after HBsAg loss between CHB patients with spontaneous and nucleos(t)ide analogue-treated HBsAg loss. 8 And this is the main strength of this cohort study. However, the main drawback is the less information about HBV DNA of the included patients.…”

mentioning

confidence: 87%

“…3 The most importance is that spontaneous loss of HBV DNA and HBsAg are important predictors of reduced HCC risk. 1,7 In a recent issue of Aliment Pharmacol Ther, Chen and coworkers 8 conducted a case-control study to explore whether there is difference of clinical outcomes between patients with spontaneous and nucleos(t)ide analogue (NAs) treated HBsAg loss. This cohort study was based on 312 CHB patients with spontaneous HBsAg loss and 110 patients with nucleos(t)ide analogue treated HBsAg loss.…”

mentioning

confidence: 99%

“…Also, patients in the nucleos(t)ide analogues treated group might have higher chance of HCC development in the long run because of the pre-existing fibrosis before and during nucleos(t)ide analogue therapy. 8 HBsAg loss was defined as persistent negativity of HBsAg for at least 1 year. 8 Patients developed HCC dozens of months after HBsAg loss.…”

mentioning

confidence: 99%

“…8 HBsAg loss was defined as persistent negativity of HBsAg for at least 1 year. 8 Patients developed HCC dozens of months after HBsAg loss. The level of HBsAg (or AE) at the time of HCC development was not described.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Letter: clinical outcomes of HBsAg loss in chronic HBV infection

Zhao

et al. 2016

Aliment Pharmacol Ther

View full text Add to dashboard Cite

SIRS, Hepatitis B surface antigen (HBsAg) loss is a milestone that marks the natural history of chronic hepatitis B virus (HBV) infection. Therefore, HBsAg loss is the most desired endpoint in chronic hepatitis B (CHB) but occurs uncommonly. This may explain that HCC can occur in the absence of cirrhosis. Considering the indications of anti-viral therapy with nucleos(t)ide analogues, more patients in the NAs treated group might be with positive or higher HBV DNA than those in the spontaneous HBsAg loss group. Therefore, more patients in the NAs treated group were with cirrhosis (20%) and HCC development (3.6%) than others (7.1% and 0.3%, respectively). Also, patients in the nucleos(t)ide analogues treated group might have higher chance of HCC development in the long run because of the pre-existing fibrosis before and during nucleos(t)ide analogue therapy.

show abstract

mentioning

confidence: 87%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Letter: clinical outcomes of HBsAg loss in chronic HBV infection

Zhao

et al. 2016

Aliment Pharmacol Ther

View full text Add to dashboard Cite

show abstract

“…HBsAg seroclearance, which is usually regarded as functional cure of chronic hepatitis B, will be the next immediate goal . HBsAg seroclearance is certainly a good endpoint for NA; it tends to be durable in about 92% to 94% of patients 3–5 years after stopping NA . Whether the durability of HBsAg seroclearance is the same after a finite duration of future new antiviral agents will need to be tested.…”

Section: Future Outlookmentioning

confidence: 99%

Okuda lecture: Challenges of hepatitis B in the era of antiviral therapy

Chan

2018

J of Gastro and Hepatol

View full text Add to dashboard Cite

Nucleos(t)ide analogs (NAs) are effective, safe, and convenient antiviral therapy to suppress replication of hepatitis B virus, which can be translated into improved long‐term outcome of chronic hepatitis B patients. The current recommended first‐line NAs, namely, entecavir and tenofovir, are largely free from problems of drug resistance. Nonetheless, there are still a few challenges in the era of NA. First, the risk of hepatocellular carcinoma can only be reduced but not eliminated, particularly among cirrhotic patients. For cirrhotic patients who have persistent low‐level viremia on NA, that is, partial responders, the risk of hepatocellular carcinoma is higher than those with complete viral suppression. The best strategy to manage partial responders to entecavir or tenofovir is uncertain. Second, immune‐tolerant patients are very difficult to treat with NA. A significant proportion of immune‐tolerant patients will have detectable viremia despite a few years of continuous NA treatment, and the rate of hepatitis B e‐antigen seroconversion is very low. Third, most patients need long‐term treatment as NA cannot eliminate covalently closed circular DNA in the hepatocytes. Some patients can consider stop NA according to treatment guidelines, but viral and clinical relapses often occur after treatment cessation. There is no concrete consensus on when one should stop NA in a hepatitis B e‐antigen‐negative patient among different treatment guidelines. New biomarkers such as hepatitis B surface antigen level can be used to select patients to stop NA, but the data are still preliminary.

show abstract

Clinical features of chronic hepatitis B patients with low hepatitis B surface antigen levels and determinants of hepatitis B surface antigen seroclearance

Taniguchi¹,

Iwasaki

Aimi³

et al. 2020

JGH Open

View full text Add to dashboard Cite

Background and Aim A low hepatitis B surface antigen (HBsAg) level is reported to be predictive of future HBsAg seroclearance. A hospital‐based cohort study was conducted to clarify the clinical features of patients with low HBsAg levels and to demonstrate the usefulness of low HBsAg levels for predicting HBsAg seroclearance. Methods A total of 1459 patients with chronic hepatitis B were included in the study. Of these, 587 had repeated measurements for HBsAg levels and two or more records of HBsAg‐positive results. HBsAg levels were measured with a commercially available HBsAg assay. Based on a cut‐off index (COI) of 2000, a high HBsAg level was defined as HBsAg ≥2000 COI, and a low HBsAg level was defined as HBsAg <2000 COI. Results The proportion of patients with low HBsAg levels at baseline tended to increase with age. Patients with low HBsAg levels at baseline had significantly older age, lower transaminase levels, and lower hepatitis B virus (HBV) DNA levels than those with high HBsAg levels. The annual HBsAg seroclearance rate was 1.30%/year. The cumulative incidences of HBsAg seroclearance differed significantly by HBsAg level at baseline (<2000 vs ≥2000 COI), age (≥50 vs <50 years), and HBV DNA level (<4.0 vs ≥4.0 log copies/mL). Cox proportional hazards regression analyses showed that low HBsAg level (<2000 COI) and low HBV DNA level (<4.0 log copies/mL) were significantly associated with HBsAg seroclearance. Conclusion Aging was one of the factors affecting HBsAg level. HBsAg seroclearance was significantly associated with low HBsAg level and low HBV DNA level at baseline.

show abstract

Clinical outcomes after spontaneous and nucleos(t)ide analogue‐treated HBsAg seroclearance in chronic HBV infection

Abstract: The clinical outcomes between patients with spontaneous and Nuc-treated HBsAg seroclearance are comparable. HCC can develop at a low rate during long-term follow-up and periodic surveillance after HBsAg seroclearance is still mandatory.

Cited by 40 publications

References 33 publications

Letter: clinical outcomes of HBsAg loss in chronic HBV infection

Letter: clinical outcomes of HBsAg loss in chronic HBV infection

Okuda lecture: Challenges of hepatitis B in the era of antiviral therapy

Clinical features of chronic hepatitis B patients with low hepatitis B surface antigen levels and determinants of hepatitis B surface antigen seroclearance

Contact Info

Product

Resources

About