HBeAg and hepatitis B virus DNA as outcome predictors during therapy with peginterferon alfa-2a for HBeAg-positive chronic hepatitis B

Fried, Michael; Piratvisuth, Teerha; Lau, George; Marcellin, Patrick; Chow, Wan Cheng; Cooksley, Graham; Luo, K.X.; Paik, Seung Woon; Liaw, Yun Fan; Button, Peter; Popescu, M.

doi:10.1002/hep.22065

Cited by 217 publications

(220 citation statements)

References 45 publications

Supporting

Mentioning

208

Contrasting

Order By: Relevance

“…Others have also reported associations with qHBeAg and clinical responses or virological breakthrough in patients treated with LAM and PEG-IFN. 17,[19][20][21] Most recently, a thorough investigation that included both qHBsAg and qHBeAg was conducted to identify their relationship with intrahepatic markers of HBV replication, and it suggested potential practical implications for these quantitative serological markers. 24 Our study is the first to report serial qHBeAg values in patients on ETV therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Briefly, qHBeAg was measured with an automated microparticle chemiluminescent immunoassay based on a previously described method. 18,21,24 Although this commercial HBeAg kit is not marketed as a quantitative assay, it produces a signal-to-cutoff ratio that is linear within a restricted range. The HBeAg reference preparation, which had a defined HBeAg activity of 100 Paul Ehrlich (PE) IU/mL, was obtained from the Paul Ehrlich Institute (Langen, Germany).…”

Section: Methodsmentioning

confidence: 99%

“…In patients receiving conventional interferon, PEG-IFN, or LAM, a decrease in qHBeAg levels during antiviral therapy might have predictive value in determining the clinical course and the occurrence of viral breakthrough. [17][18][19][20][21] However, no study exploring qHBeAg changes in patients receiving ETV therapy has yet been conducted.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Quantitative hepatitis B surface antigen and hepatitis B e antigen titers in prediction of treatment response to entecavir

et al. 2011

View full text Add to dashboard Cite

Quantitative hepatitis B surface antigen (qHBsAg) and quantitative hepatitis B e antigen (qHBeAg) titers are emerging as useful tools for measuring viral loads and for predicting the virological response (VR) and serological response (SR) to pegylated interferon therapy. However, the clinical utility of these assays in patients taking entecavir (ETV) is largely unknown. Treatment-naive patients with chronic hepatitis B (CHB) who were taking ETV for 2 years were enrolled. The qHBsAg and qHBeAg levels were serially measured with the Architect assay. From 95 patients, 60.0% of whom were hepatitis B e antigen-positive [HBeAg(1)], 475 samples were analyzed. The median baseline log hepatitis B virus (HBV) DNA, log qHBsAg, and log qHBeAg values were 6.73 copies/mL (4.04-9.11 copies/mL), 3.58 IU/mL (1.17-5.10 IU/ mL), and 1.71 Paul Ehrlich (PE) IU/mL (20.64 to 2.63 PE IU/mL), respectively. For the prediction of VR (HBV DNA < 60 copies/mL at 24 months) in HBeAg(1) patients, baseline alanine aminotransferase (P 5 0.013), HBV DNA (P 5 0.040), and qHBsAg levels (P 5 0.033) were significant. For the prediction of VR, the area under the curve for the baseline log qHBsAg level was 0.823 (P < 0.001); a cutoff level of 3.98 IU/mL (9550 IU/mL on a nonlogarithmic scale) yielded the highest predictive value with a sensitivity of 86.8% and a specificity of 78.9%. As for SR (HBeAg loss at 24 months), the reduction of qHBeAg was significantly greater in the SR(1) group versus the SR(2) group. The sensitivity and specificity were 75.0% and 89.8%, respectively, with a decline of 1.00 PE IU/mL at 6 months. With ETV therapy, the correlation between HBV DNA and qHBsAg peaked at 6 months in HBeAg(1) patients. Conclusion: Both qHBsAg and qHBeAg decreased significantly with ETV therapy. The baseline qHBsAg levels and the on-treatment decline of qHBeAg in HBeAg(1) patients were proven to be highly useful in predicting VR and SR, respectively. The determination of qHBsAg and qHBeAg can help us to select the appropriate strategy for the management of patients with CHB. However, the dynamic interplay between qHBsAg, qHBeAg, and HBV DNA during antiviral therapy remains to be elucidated. (HEPATOLOGY 2011;53:1486-1493 C hronic infection with hepatitis B virus (HBV) is a worldwide health problem, with more than 400 million people thought to be infected.Moreover, these patients are at increased risk for disease progression to cirrhosis and hepatocellular carcinoma. 1 Large cohort studies have shown that elevated levels of Abbreviations: ALT, alanine aminotransferase; anti-HBs, antibody to hepatitis B surface antigen; AUC, area under the curve; AUROC, area under the receiver operating characteristic

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Quantitative hepatitis B surface antigen and hepatitis B e antigen titers in prediction of treatment response to entecavir

et al. 2011

View full text Add to dashboard Cite

show abstract

“…60 Based on the data of a randomized international study using PEG-IFN alpha-2a as monotherapy, a much higher cutoff, of 9 log copies/mL in week 24, was described as presenting a negative predictive value of 86% for sustained seroconversion of HBeAg. 61 Whether or not the difference between these two studies is related to the nature of the two PEG-IFN requires further investigation. However, early kinetics of HBV-DNA can help the clinical decision-making of therapeutic withdrawal, particularly among patients that do not present good tolerance to the treatment.…”

Section: Serum Hbv-dnamentioning

confidence: 99%

Response predictors to treatment with pegylated interferon in chronic hepatitis B

Ferreira

Tenore

2010

Braz J Infect Dis

View full text Add to dashboard Cite

The clinical and epidemiological importance of chronic B hepatitis is currently unquestionable as a cause of end-stage liver disease and hepatocellular carcinoma. Recently, predictors of treatment response of this disease have been studied, both before and during the course of medication. Therapy stopping rules have been proposed, which may be useful in patients presenting poor treatment tolerance. This review discusses the treatment response predictors usefulness, with emphasis on ALT, quantitative HBsAg and HBeAg, quantitative HBV-DNA and HBV genotyp

show abstract

“…As was also recently proposed for hepatitis C patients 2 , the use of customized treatment for each patient may increase the likelihood of a response, and following up on HBV DNA and HBeAg levels helps in choosing the best treatment for each patient as well in predicting treatment response. It must be emphasized that stopping rules based on HBV DNA determination for PEG-IFN treatment could not be established 10 . Furthermore, our data suggests that the period of 48 weeks for the discontinuation of PEG-IFN may be too short in some patients.…”

mentioning

confidence: 99%

Simultaneous quantitation of serum HBV DNA and HBeAg can distinguish between slow and fast viral responses to antiviral therapy in patients with chronic hepatitis B

Silva

Nova

Ono‐Nita

et al. 2009

Rev. Inst. Med. trop. S. Paulo

View full text Add to dashboard Cite

SUMMARY Background:The quantitation of serum HBeAg is not commonly used to monitor viral response to therapy in chronic hepatitis B. Methods: In this study, 21 patients receiving varying therapies were followed and their viral response monitored by concomitant viral load and HBeAg quantitation in order to study the meaning and the kinetics of both parameters. Results: It was possible to distinguish between three different patterns of viral response. The first was characterized by a simultaneous decrease in serum HBV DNA and HBeAg. The second pattern was characterized by a decrease in serum HBeAg but persistent detection of HBV DNA. The third pattern was characterized by undetectable HBV DNA with persistent HBeAg positivity, which points to a non-response (Pattern III-B) except when HBeAg levels showed a slow but steady drop, characterizing a "slow responder" patient (Pattern III-A). Conclusions: The first pattern is compatible with a viral response. A long-term HBeAg seropositivity with a slow and persistent decrease (Pattern III-A) is also compatible with a viral response and calls for a prolongation of anti-viral treatment.

show abstract

HBeAg and hepatitis B virus DNA as outcome predictors during therapy with peginterferon alfa-2a for HBeAg-positive chronic hepatitis B

Cited by 217 publications

References 45 publications

Quantitative hepatitis B surface antigen and hepatitis B e antigen titers in prediction of treatment response to entecavir

Quantitative hepatitis B surface antigen and hepatitis B e antigen titers in prediction of treatment response to entecavir

Response predictors to treatment with pegylated interferon in chronic hepatitis B

Simultaneous quantitation of serum HBV DNA and HBeAg can distinguish between slow and fast viral responses to antiviral therapy in patients with chronic hepatitis B

Contact Info

Product

Resources

About