Clinical outcomes and predictors for relapse after cessation of oral antiviral treatment in chronic hepatitis B patients

Kyu Sik Jung, Jun Yong Park, Young Eun Chon, Hyon Suk Kim, Wonseok Kang, Beom Kyung Kim, Seung Up Kim, Do Young Kim, Kwang Hyub Han, Sang Hoon Ahn

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Background: Little is known about stopping rules of nucelos(t)ide analog (NA) treatment for chronic hepatitis B (CHB). Methods: A total of 113 consecutive patients with CHB (45 HBeAg-positive and 68 HBeAg-negative CHB patients), who met the cessation criteria of NA treatment as per the Asian-Pacific Association for the Study of the Liver (APASL) guideline, were enrolled in this prospective cohort study. The primary endpoint was to evaluate virological relapse (VR) rate within 1 year, which was defined as reappearance of hepatitis B virus (HBV)–DNA > 2000 IU/mL after cessation of NA treatment. In this cohort, entecavir was used in 81 (71.7 %) and lamivudine in 32 (28.3 %) patients. Results: Within 1 year after NA treatment, VR occurred in 26 (57.8 %) HBeAg-positive patients and in 37 (54.4 %) HBeAg-negative patients. In univariate and subsequent multivariate analysis, age > 40 years [odds ratio (OR) 10.959; 95 % confidence interval (CI) 2.211–54.320; P = 0.003) and a pre-treatment HBV DNA level >2000,000 IU/mL (OR 9.285; 95 % CI 1.545–55.795; P = 0.036) were identified as independent risk factors for VR in HBeAg-positive patients, and age > 40 years (OR 6.690; 95 % CI 1.314–34.057; P = 0.022) and an end-of-treatment HBcrAg level >3.7 log IU/mL (OR 3.751; 95 % CI 1.187–11.856; P = 0.024) were identified in HBeAg-negative patients. During follow up, neither hepatic decompensation nor hepatocellular carcinoma (HCC) occurred, and HBV DNA suppression was achieved in all patients who received antiviral re-treatment. Conclusion: Our data suggested that the APASL stopping rule could be applied if a candidate was properly selected using individual risk factors. However, regular monitoring should be performed after cessation of NA treatment and long-term outcomes need to be evaluated further.

Original languageEnglish
Pages (from-to)830-839
Number of pages10
JournalJournal of Gastroenterology
Volume51
Issue number8
DOIs
Publication statusPublished - 2016 Aug 1

Fingerprint

Chronic Hepatitis B
Antiviral Agents
Hepatitis B e Antigens
Recurrence
Odds Ratio
Hepatitis B virus
Confidence Intervals
Withholding Treatment
Therapeutics
DNA
Lamivudine
Liver
Hepatocellular Carcinoma
Cohort Studies
Multivariate Analysis
Prospective Studies
Guidelines

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

@article{12e5d7db24a3453d8648c3f18e917cda,
title = "Clinical outcomes and predictors for relapse after cessation of oral antiviral treatment in chronic hepatitis B patients",
abstract = "Background: Little is known about stopping rules of nucelos(t)ide analog (NA) treatment for chronic hepatitis B (CHB). Methods: A total of 113 consecutive patients with CHB (45 HBeAg-positive and 68 HBeAg-negative CHB patients), who met the cessation criteria of NA treatment as per the Asian-Pacific Association for the Study of the Liver (APASL) guideline, were enrolled in this prospective cohort study. The primary endpoint was to evaluate virological relapse (VR) rate within 1 year, which was defined as reappearance of hepatitis B virus (HBV)–DNA > 2000 IU/mL after cessation of NA treatment. In this cohort, entecavir was used in 81 (71.7 {\%}) and lamivudine in 32 (28.3 {\%}) patients. Results: Within 1 year after NA treatment, VR occurred in 26 (57.8 {\%}) HBeAg-positive patients and in 37 (54.4 {\%}) HBeAg-negative patients. In univariate and subsequent multivariate analysis, age > 40 years [odds ratio (OR) 10.959; 95 {\%} confidence interval (CI) 2.211–54.320; P = 0.003) and a pre-treatment HBV DNA level >2000,000 IU/mL (OR 9.285; 95 {\%} CI 1.545–55.795; P = 0.036) were identified as independent risk factors for VR in HBeAg-positive patients, and age > 40 years (OR 6.690; 95 {\%} CI 1.314–34.057; P = 0.022) and an end-of-treatment HBcrAg level >3.7 log IU/mL (OR 3.751; 95 {\%} CI 1.187–11.856; P = 0.024) were identified in HBeAg-negative patients. During follow up, neither hepatic decompensation nor hepatocellular carcinoma (HCC) occurred, and HBV DNA suppression was achieved in all patients who received antiviral re-treatment. Conclusion: Our data suggested that the APASL stopping rule could be applied if a candidate was properly selected using individual risk factors. However, regular monitoring should be performed after cessation of NA treatment and long-term outcomes need to be evaluated further.",
author = "Jung, {Kyu Sik} and Park, {Jun Yong} and Chon, {Young Eun} and Kim, {Hyon Suk} and Wonseok Kang and Kim, {Beom Kyung} and Kim, {Seung Up} and Kim, {Do Young} and Han, {Kwang Hyub} and Ahn, {Sang Hoon}",
year = "2016",
month = "8",
day = "1",
doi = "10.1007/s00535-015-1153-1",
language = "English",
volume = "51",
pages = "830--839",
journal = "Journal of Gastroenterology",
issn = "0944-1174",
publisher = "Springer Japan",
number = "8",

}

Clinical outcomes and predictors for relapse after cessation of oral antiviral treatment in chronic hepatitis B patients. / Jung, Kyu Sik; Park, Jun Yong; Chon, Young Eun; Kim, Hyon Suk; Kang, Wonseok; Kim, Beom Kyung; Kim, Seung Up; Kim, Do Young; Han, Kwang Hyub; Ahn, Sang Hoon.

In: Journal of Gastroenterology, Vol. 51, No. 8, 01.08.2016, p. 830-839.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical outcomes and predictors for relapse after cessation of oral antiviral treatment in chronic hepatitis B patients

AU - Jung, Kyu Sik

AU - Park, Jun Yong

AU - Chon, Young Eun

AU - Kim, Hyon Suk

AU - Kang, Wonseok

AU - Kim, Beom Kyung

AU - Kim, Seung Up

AU - Kim, Do Young

AU - Han, Kwang Hyub

AU - Ahn, Sang Hoon

PY - 2016/8/1

Y1 - 2016/8/1

N2 - Background: Little is known about stopping rules of nucelos(t)ide analog (NA) treatment for chronic hepatitis B (CHB). Methods: A total of 113 consecutive patients with CHB (45 HBeAg-positive and 68 HBeAg-negative CHB patients), who met the cessation criteria of NA treatment as per the Asian-Pacific Association for the Study of the Liver (APASL) guideline, were enrolled in this prospective cohort study. The primary endpoint was to evaluate virological relapse (VR) rate within 1 year, which was defined as reappearance of hepatitis B virus (HBV)–DNA > 2000 IU/mL after cessation of NA treatment. In this cohort, entecavir was used in 81 (71.7 %) and lamivudine in 32 (28.3 %) patients. Results: Within 1 year after NA treatment, VR occurred in 26 (57.8 %) HBeAg-positive patients and in 37 (54.4 %) HBeAg-negative patients. In univariate and subsequent multivariate analysis, age > 40 years [odds ratio (OR) 10.959; 95 % confidence interval (CI) 2.211–54.320; P = 0.003) and a pre-treatment HBV DNA level >2000,000 IU/mL (OR 9.285; 95 % CI 1.545–55.795; P = 0.036) were identified as independent risk factors for VR in HBeAg-positive patients, and age > 40 years (OR 6.690; 95 % CI 1.314–34.057; P = 0.022) and an end-of-treatment HBcrAg level >3.7 log IU/mL (OR 3.751; 95 % CI 1.187–11.856; P = 0.024) were identified in HBeAg-negative patients. During follow up, neither hepatic decompensation nor hepatocellular carcinoma (HCC) occurred, and HBV DNA suppression was achieved in all patients who received antiviral re-treatment. Conclusion: Our data suggested that the APASL stopping rule could be applied if a candidate was properly selected using individual risk factors. However, regular monitoring should be performed after cessation of NA treatment and long-term outcomes need to be evaluated further.

AB - Background: Little is known about stopping rules of nucelos(t)ide analog (NA) treatment for chronic hepatitis B (CHB). Methods: A total of 113 consecutive patients with CHB (45 HBeAg-positive and 68 HBeAg-negative CHB patients), who met the cessation criteria of NA treatment as per the Asian-Pacific Association for the Study of the Liver (APASL) guideline, were enrolled in this prospective cohort study. The primary endpoint was to evaluate virological relapse (VR) rate within 1 year, which was defined as reappearance of hepatitis B virus (HBV)–DNA > 2000 IU/mL after cessation of NA treatment. In this cohort, entecavir was used in 81 (71.7 %) and lamivudine in 32 (28.3 %) patients. Results: Within 1 year after NA treatment, VR occurred in 26 (57.8 %) HBeAg-positive patients and in 37 (54.4 %) HBeAg-negative patients. In univariate and subsequent multivariate analysis, age > 40 years [odds ratio (OR) 10.959; 95 % confidence interval (CI) 2.211–54.320; P = 0.003) and a pre-treatment HBV DNA level >2000,000 IU/mL (OR 9.285; 95 % CI 1.545–55.795; P = 0.036) were identified as independent risk factors for VR in HBeAg-positive patients, and age > 40 years (OR 6.690; 95 % CI 1.314–34.057; P = 0.022) and an end-of-treatment HBcrAg level >3.7 log IU/mL (OR 3.751; 95 % CI 1.187–11.856; P = 0.024) were identified in HBeAg-negative patients. During follow up, neither hepatic decompensation nor hepatocellular carcinoma (HCC) occurred, and HBV DNA suppression was achieved in all patients who received antiviral re-treatment. Conclusion: Our data suggested that the APASL stopping rule could be applied if a candidate was properly selected using individual risk factors. However, regular monitoring should be performed after cessation of NA treatment and long-term outcomes need to be evaluated further.

UR - http://www.scopus.com/inward/record.url?scp=84950274075&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84950274075&partnerID=8YFLogxK

U2 - 10.1007/s00535-015-1153-1

DO - 10.1007/s00535-015-1153-1

M3 - Article

C2 - 26687058

AN - SCOPUS:84950274075

VL - 51

SP - 830

EP - 839

JO - Journal of Gastroenterology

JF - Journal of Gastroenterology

SN - 0944-1174

IS - 8

ER -