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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Kinetics of hepatitis B surface antigen decline during 3 years of telbivudine treatment in hepatitis B e antigen-positive patients
Hepatology, Volume 52, No. 5, Year 2010
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Description
The impact of prolonged direct antiviral therapy on hepatitis B surface antigen (HBsAg) levels in patients with chronic hepatitis B is poorly understood. We quantitatively assessed serum HBsAg levels during 3 years of telbivudine treatment, as well as their relationship with virologic and biochemical characteristics in 162 hepatitis B e antigen-positive patients who maintained undetectable serum hepatitis B virus (HBV) DNA long-term. Telbivudine treatment progressively reduced serum HBsAg levels (mean ± SD) from baseline (3.8 ± 0.6 log10 IU/mL) to treatment week 24 (3.4 ± 0.7 log10 IU/mL), treatment year 1 (3.3 ± 0.8 log10 IU/mL), and treatment year 3 (3.0 ± 1.4 log10 IU/mL) (P <0.0001). In this patient population, HBsAg loss was observed in nine (6%) of 162 patients through year 3. During the first year of treatment, three patterns of HBsAg decline were observed: rapid (≥1 log10 IU/mL) in 32 patients, slow (0-1 log10 IU/mL) in 74 patients, and steady levels in 56 patients. These findings were associated with different likelihoods of HBsAg loss during long-term telbivudine therapy. Eight of 32 patients with rapid HBsAg decline versus none of 56 patients with steady HBsAg levels achieved HBsAg loss at year 3 (P = 0.0024). HBV genotype was a significant determinant for HBsAg kinetics, with the fastest decline in genotype A patients. In patients with subsequent HBsAg loss, viral antigens were already undetectable in liver biopsy samples after 1 year of treatment. This was associated with markedly enhanced antiviral T cell reactivity. Conclusion: In patients who have effective suppression of viral replication during telbivudine treatment, a rapid decline in serum HBsAg levels during the first year may identify those with a greater likelihood of achieving HBsAg clearance. © 2010 American Association for the Study of Liver Diseases.
Authors & Co-Authors
Wursthorn, Karsten
Germany, Hannover
Hannover Medical School
Jung, Mechthild
Swaziland, Basel
Novartis Pharma ag
Riva, Antonio
United Kingdom, London
University College London
Goodman, Zachary D.
United States, Silver Spring
American International Pathology Laboratories
Lopez, Patricia
Swaziland, Basel
Novartis Pharma ag
Bao, Weibin
Switzerland, Basel
Novartis International ag
Manns, Michael Peter
Germany, Hannover
Hannover Medical School
Wedemeyer, Heiner
Germany, Hannover
Hannover Medical School
Naoumov, Nikolai V.
Swaziland, Basel
Novartis Pharma ag
Statistics
Citations: 212
Authors: 9
Affiliations: 5
Identifiers
Doi:
10.1002/hep.23905
ISSN:
02709139
Research Areas
Genetics And Genomics
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study