Predictors of relapse after cessation of nucleos(t)ide analog treatment in HBeAg-negative chronic hepatitis B patients: A meta-analysis

Liu, Yun; Jia, Minglei; Wu, Shengdi; Jiang, Wei; Feng, Yifan

doi:10.1016/j.ijid.2019.07.036

Cited by 22 publications

(28 citation statements)

References 29 publications

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“…By analyzing published data from 14 articles, Liu et al found that baseline and EOT HBsAg levels could be biomarkers for predicting HBV relapse in HBeAg‐negative CHB patients who discontinued NAs treatment 20 . Besides the baseline HBsAg level, there was a strong connection between EOT HBsAg level and CR or VR in NAs treated CHB patients, lower EOT HBsAg might be a pivotal biomarker in guiding NAs cessation 8,21–24 .…”

Section: Resultsmentioning

confidence: 99%

Biomarkers for predicting nucleos(t)ide analogs discontinuation and hepatitis B virus recurrence after drug withdrawal in chronic hepatitis B patients

Luo

Zhou

Hou

et al. 2022

Hepatology Research

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Aim: To summarize HBV-related biomarkers predicting nucleos(t)ide analogs (NAs) discontinuation and hepatitis B virus (HBV) recurrence after drug withdrawal in chronic hepatitis B (CHB) patients, providing references for clinical medication, so as to manage CHB patients more scientifically.Methods: Related pieces of literature were retrieved in PubMed and the results were sorted out. We then analyzed and summarized these articles. Results:We found that HBV related biomarkers maybe could predict NAs withdrawal safely and the possibility of relapse after treatment cessation, including hepatitis B e antigen (HBeAg), hepatitis B surface antigen (HBsAg), HBV DNA, HBV RNA, pregenomic-RNA (pgRNA), hepatitis B core-related antigen (HBcrAg), hepatitis B core antibody (anti-HBc), and models containing several indicators for predicting the effectiveness of treatment.Conclusions: HBV DNA, HBV RNA, pgRNA, HBcrAg, anti-HBc, as well as the prediction models formed by several biomarkers could predict the safe discontinuation of NAs before HBsAg loss and recurrence.

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Section: Resultsmentioning

confidence: 99%

Biomarkers for predicting nucleos(t)ide analogs discontinuation and hepatitis B virus recurrence after drug withdrawal in chronic hepatitis B patients

Luo

Zhou

Hou

et al. 2022

Hepatology Research

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“…The high rates of relapse (69.2%) in HBeAg positive children in the present study suggests that treatment withdrawal should not be attempted in absence of HBeAg seroconversion. The important predictors of relapse after stopping antivirals in adults include (i) higher qHBsAg level at the time of stopping the therapy [18-21]; (ii) shorter duration of consolidation therapy [19][20][22][23][24]; (iii) slower HBV-DNA decline while on therapy [25]; (iv) baseline pre-treatment HBV-DNA [26-27]; (v) hepatitis B core-related antigen (HBcrAg) [28][29]; and (vi) hepatitis B virus-ribonucleic acid (HBV-RNA [29]. The emphasis is maximum on qHBsAg levels at the time of stopping therapy and recently Asia Paci c Association for Study of Liver Diseases (APASL) has suggested qHBsAg less than 100 IU/ml as a safe endpoint for stopping long term antivirals [18].…”

Section: Discussionmentioning

confidence: 99%

Incidence And Predictors of Relapse After Stopping Antiviral Therapy In Pediatric Chronic Hepatitis B

Upadhyay

Lal

Sood

et al. 2021

Preprint

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Objective: The objective was to evaluate the incidence of relapse after stopping antiviral therapy and to identify the predictors of relapse. Methods: All HBsAg positive children with who had been on antivirals for at least 2 years with undetectable HBV-DNA and normal alanine-aminotransferase (ALT) on three consecutive occasions over last 12 months were included. Antivirals were stopped if liver biopsy showed histological activity index <5 and fibrosis (metavir) <3. Children were monitored for virological relapse (elevation of HBV-DNA >2000 IU/mL) and biochemical relapse (ALT levels >2 × upper limit of normal (ULN)). Those having biochemical relapse were started on pegylated interferon alpha-2b based sequential therapy. Results: Antivirals were stopped in 31 HBsAg positive children. Virological and biochemical relapse was seen in 12 (38.7%) and 5 (16.1%) children within 12 months of stopping antiviral treatment. Majority of virological relapse occurred within a month and biochemical relapses within 6 months of stopping therapy. HBeAg positive status at the time of stopping antiviral therapy (HR: 7.206, p =0.005) and longer time taken for HBV-DNA to become undetectable while on antivirals (HR: 1.030, p=0.037) were found to be the 2 independent predictors of relapse after stopping antiviral treatment. Conclusion: Discontinuation of antiviral treatment in children with CHB resulted in relapse in one third of the patients. Relapse was more common in those with HBeAg positivity at the time of stopping therapy and in those with longer time taken for HBV-DNA to become undetectable on antivirals.

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“…In some cases, age has been used as a predictor of reactivation after treatment which may be due to the power of immune system at different ages (24).…”

Section: Discussionmentioning

confidence: 99%

HBV DNA in the Plasma and Peripheral Blood Mononuclear Cells in Chronic HBV Infected Individuals Who Became HBsAg-Serocleared or Seroconverted

et al. 2019

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Background: Hepatitis B virus (HBV) is responsible for chronic hepatitis B (CHB) and liver diseases. In the event of seroclearance or seroconversion, hepatitis B surface antigen (HBsAg) may be cleared or reduced to levels below the detection limit but very low quantities of viral DNA may be detectable as occult HBV infection (OBI). Objectives: This study was conducted to estimate the prevalence of HBV DNA in the serum and PBMCs of individuals with HBsAg loss, with or without anti-HBs. Methods: Sixty out of 1116 patients who referred to the private clinic were selected and divided into two groups: serocleared and seroconverted. Serological markers of HBV were measured by ELISA assay and HBV DNA in the plasma and peripheral blood mononuclear cell (PBMC) were measured by quantitative real time PCR. Results: A total of sixty cases (38 males, 22 females) with chronic hepatitis B were enrolled. The mean age of serocleared and seroconverted groups was 50.5 ± 13.1and 49 ± 11, respectively. Among the serocleared and seroconverted subjects, 3 and 2 became HBsAg positive, respectively. HBV DNA was detected in the PBMCs of four out of 27 serocleared patients (14.8%) and three out of 28 seroconverted (10.7%). By multivariate analysis, age, gender, duration of disease and serological situation of patients had no effects on patients' relapse (P > 0.05). Conclusions: In patients with CHB, who became HBsAg negative if the serum antibody is formed, there is a possibility of disease recurrence. Moreover, recurrence may be predicted considering the viral load in PBMCs.

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Predictors of relapse after cessation of nucleos(t)ide analog treatment in HBeAg-negative chronic hepatitis B patients: A meta-analysis

Cited by 22 publications

References 29 publications

Biomarkers for predicting nucleos(t)ide analogs discontinuation and hepatitis B virus recurrence after drug withdrawal in chronic hepatitis B patients

Biomarkers for predicting nucleos(t)ide analogs discontinuation and hepatitis B virus recurrence after drug withdrawal in chronic hepatitis B patients

Incidence And Predictors of Relapse After Stopping Antiviral Therapy In Pediatric Chronic Hepatitis B

HBV DNA in the Plasma and Peripheral Blood Mononuclear Cells in Chronic HBV Infected Individuals Who Became HBsAg-Serocleared or Seroconverted

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