Hepatitis B surface antigen loss and sustained viral suppression in Asian chronic hepatitis B patients: A community‐based real‐world study

Journal of Viral Hepatitis - Tập 24 Số 12 - Trang 1089-1097 - 2017
Robert J. Wong1, Mai Thanh Thi Nguyen2, Huy N. Trinh3, C. K. Chan1, Andrew Huynh2, M. T. Ly2, Huy Nguyen3, Khanh K. Nguyen3, Sharon Torres1, J. Yang3, B. Liu1, Ruel T. Garcia3, Taft Bhuket1, Rachel Baden1, Brian S. Levitt3, Eduardo Silveira3, Robert G. Gish4,5
1Division of Gastroenterology and Hepatology Alameda Health System – Highland Hospital Oakland CA USA
2Silicon Valley Research Institute, San Jose, CA, USA
3San Jose Gastroenterology, San Jose, CA, USA
4Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, Stanford, CA, USA
5Hepatitis B Foundation, Doylestown, PA, USA

Tóm tắt

SummaryCommunity‐based real‐world outcomes on effectiveness of antiviral therapies for chronic hepatitis B virus (CHB) in Asians are limited. Whether hepatitis B surface antigen (HBsAg) loss correlates with undetectable virus and alanine aminotransferase (ALT) normalization on treatment or what predicts risk of seroreversion or detectable virus after stopping therapy is unclear. We aim to evaluate rates and predictors of HBsAg loss, seroconversion, ALT normalization and undetectable HBV DNA, including HBsAg seroreversion or re‐emergence of HBV DNA among Asian CHB patients. We retrospectively evaluated 1072 CHB adults on antiviral therapy at two community gastroenterology clinics from 1997 to 2015. Rates of HBsAg loss, ALT normalization, achieving undetectable HBV DNA and developing surface antibody (anti‐HBs) were stratified by HBeAg status. Following HBsAg loss, HBsAg seroreversion or re‐emergence of detectable HBV DNA was analysed. With median treatment of 76.7 months, the overall rate of HBsAg loss was 4.58%, with similar HBsAg loss rates between HBeAg‐positive and HBeAg‐negative patients (4.44% vs 4.71%, P=.85) in a predominantly Asian population (98.1%). Among HBsAg loss patients, 33.3% developed anti‐HBs, 95.8% achieved undetectable virus and 66.0% normalized ALT. No significant baseline or on‐treatment predictors of HBsAg loss were observed. While six patients who achieved HBsAg loss had seroreversion with re‐emergence of HBsAg positivity, viral load remained undetectable, demonstrating the sustainability of viral suppression. Among a large community‐based real‐world cohort of Asian CHB patients treated with antiviral therapy, rate of HBsAg loss was 4.58%. Despite only 33.3% of HBsAg loss patients achieving anti‐HBs, nearly all patients achieved sustained undetectable virus.

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Thông tin xuất bản

Journal of Viral Hepatitis

Tập 24 Số 12

1089-1097

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