Durability of HBeAg seroconversion following antiviral therapy for chronic hepatitis B: relation to type of therapy and pretreatment serum hepatitis B virus DNA and alanine aminotransferase
| Autor: | H F Löhr, B C Song, S.W. Schalm, Jenny Heathcote, H.L.A. Janssen, H. Fontaine, Liliana Chemello, D J Suh, Bettina E. Hansen, R.A. de Man, A.B. van Nunen |
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| Přispěvatelé: | Internal Medicine, Gastroenterology & Hepatology |
| Jazyk: | angličtina |
| Rok vydání: | 2003 |
| Předmět: |
Adult
Male Hepatitis B virus Combination therapy medicine.disease_cause Antiviral Agents Hepatitis D-Alanine Transaminase Hepatitis B Chronic SDG 3 - Good Health and Well-being medicine Humans Hepatitis B e Antigens Hepatitis B Antibodies Seroconversion biology business.industry Gastroenterology virus diseases Lamivudine Alanine Transaminase Middle Aged Hepatitis B medicine.disease digestive system diseases HBeAg Alanine transaminase DNA Viral Multivariate Analysis Immunology biology.protein Drug Therapy Combination Female Interferons Liver function business medicine.drug |
| Zdroj: | Gut, 52, 420-424. BMJ Publishing Group |
| ISSN: | 0017-5749 |
| Popis: | Background and aims: Interferon (IFN) induced hepatitis B e antigen (HBeAg) seroconversion is durable in 80–90% of chronic hepatitis B patients. Preliminary reports on the durability of HBeAg seroconversion following lamivudine are contradictory. We investigated the durability of response following IFN, lamivudine, or IFN-lamivudine combination therapy in a meta-analysis of individual patient data. Patients and methods: Twenty four centres included 130 patients in total with an HBeAg seroconversion (HBeAg negative, antibodies to hepatitis B e antigen positive) at the end of antiviral therapy: 59 with lamivudine, 49 with interferon, and 22 with combination therapy. Relapse was defined as confirmed reappearance of HBeAg. Results: The three year cumulative HBeAg relapse rate by the Kaplan-Meier method was 54% for lamivudine, 32% for IFN, and 23% for combination therapy (p=0.01). Cox regression analysis identified pretreatment hepatitis B virus (HBV) DNA, alanine aminotransferase (ALT), sex, and therapy as independent predictive factors of post-treatment relapse; Asian race, previous therapy, centre, and type of study were not predictive of relapse. The relative HBeAg relapse risk of lamivudine compared with IFN therapy was 4.6 and that of combination therapy to IFN therapy 0.7 (p overall =0.01). Conclusions: The durability of HBeAg seroconversion following lamivudine treatment was significantly lower than that following IFN or IFN-lamivudine combination therapy. The risk of relapse after HBeAg seroconversion was also related to pretreatment levels of serum ALT and HBV DNA, but independent of Asian race. |
| Databáze: | OpenAIRE |
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