The Incidence of Hepatitis B Surface Antigen Loss Between Hepatitis B E Antigen-Negative Noncirrhotic Patients Who Discontinued or Continued Entecavir Therapy.


Journal

The Journal of infectious diseases
ISSN: 1537-6613
Titre abrégé: J Infect Dis
Pays: United States
ID NLM: 0413675

Informations de publication

Date de publication:
19 04 2019
Historique:
received: 29 07 2018
accepted: 20 12 2018
pubmed: 29 1 2019
medline: 7 1 2020
entrez: 29 1 2019
Statut: ppublish

Résumé

We compared rates of hepatitis B surface antigen (HBsAg) loss and hepatocellular carcinoma (HCC) development in hepatitis B e antigen (HBeAg)-negative patients without cirrhosis who continued or discontinued entecavir. Patients who discontinued entecavir treatment for at least 12 months (discontinued group; n = 234) and patients who continued entecavir treatment for at least 4 years (continued group; n = 226) were recruited. In the discontinued group, the 5-year cumulative incidences of virological relapse (VR), clinical relapse (CR), and HBsAg loss were 71.9%, 58.9%, and 13%, respectively. Patients with sustained response, VR but no CR, and CR without retreatment were 49-, 13-, and 18-fold more likely to develop HBsAg loss than those with retreatment. Patients who discontinued entecavir therapy had a higher rate of HBsAg loss than those who continued entecavir therapy, in all and 360 propensity score (PS)-matched patients. Cox regression analysis revealed that the discontinued group was an independent predictor for HBsAg loss. There was no significant difference in HCC development between the 2 groups in all and PS-matched patients. HBeAg-negative patients without cirrhosis who discontinued entecavir treatment exhibited a higher HBsAg loss rate without an increased risk of HCC compared to those who continued entecavir treatment.

Sections du résumé

BACKGROUND
We compared rates of hepatitis B surface antigen (HBsAg) loss and hepatocellular carcinoma (HCC) development in hepatitis B e antigen (HBeAg)-negative patients without cirrhosis who continued or discontinued entecavir.
METHODS
Patients who discontinued entecavir treatment for at least 12 months (discontinued group; n = 234) and patients who continued entecavir treatment for at least 4 years (continued group; n = 226) were recruited.
RESULTS
In the discontinued group, the 5-year cumulative incidences of virological relapse (VR), clinical relapse (CR), and HBsAg loss were 71.9%, 58.9%, and 13%, respectively. Patients with sustained response, VR but no CR, and CR without retreatment were 49-, 13-, and 18-fold more likely to develop HBsAg loss than those with retreatment. Patients who discontinued entecavir therapy had a higher rate of HBsAg loss than those who continued entecavir therapy, in all and 360 propensity score (PS)-matched patients. Cox regression analysis revealed that the discontinued group was an independent predictor for HBsAg loss. There was no significant difference in HCC development between the 2 groups in all and PS-matched patients.
CONCLUSIONS
HBeAg-negative patients without cirrhosis who discontinued entecavir treatment exhibited a higher HBsAg loss rate without an increased risk of HCC compared to those who continued entecavir treatment.

Identifiants

pubmed: 30689910
pii: 5299647
doi: 10.1093/infdis/jiy697
doi:

Substances chimiques

Antiviral Agents 0
Hepatitis B Surface Antigens 0
entecavir 5968Y6H45M
Guanine 5Z93L87A1R

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1624-1633

Informations de copyright

© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Auteurs

Chien-Hung Chen (CH)

Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine.

Chao-Hung Hung (CH)

Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine.

Jing-Houng Wang (JH)

Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine.

Sheng-Nan Lu (SN)

Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine.

Hsueh-Chou Lai (HC)

Division of Hepatogastroenterology, Department of Internal Medicine.

Tsung-Hui Hu (TH)

Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine.

Chia-Hsin Lin (CH)

Division of Hepatogastroenterology, Department of Internal Medicine.

Cheng-Yuan Peng (CY)

Division of Hepatogastroenterology, Department of Internal Medicine.
School of Medicine, China Medical University, Taichung, Taiwan.

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Classifications MeSH