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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Durability of Hepatitis B Surface Antigen Loss With Nucleotide Analogue and Peginterferon Therapy in Patients With Chronic Hepatitis B
Hepatology Communications, Volume 4, No. 1, Year 2020
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Description
In patients with chronic hepatitis B (CHB), loss of hepatitis B surface antigen (HBsAg) is considered a functional cure. However, HBsAg loss is uncommon with existing therapies, and predictive factors associated with HBsAg seroreversion are unknown. Using pooled data from three phase 3 clinical trials of patients with CHB treated with nucleos(t)ide analogue (NUC) monotherapy or peginterferon (Peg-IFN) ± NUC combination therapy, we conducted a retrospective analysis to characterize patients who achieved sustained HBsAg loss, the predictors of HBsAg seroreversion, and the impact of hepatitis B surface antibody (anti-HBs) seroconversion on durability of HBsAg loss. In these three international trials, 1,381 adults with CHB received either NUC monotherapy for up to 10 years or Peg-IFN-containing regimens for up to 1 year. A total of 55 patients had confirmed HBsAg loss, defined as two or more consecutive negative-qualitative HBsAg results, with a minimum of one repeat result after the end of treatment. Throughout a median of 96 (quartile [Q]1, Q3, 46, 135) weeks follow-up after HBsAg loss, HBsAg loss was durable in 82% (n = 45) of patients, with 10 patients experiencing HBsAg seroreversion. Anti-HBs seroconversion was observed during follow-up in 78% of patients who lost HBsAg and in 60% of those who subsequently seroreverted. In analyzing predictors of HBsAg seroreversion, study treatment was significant, yet anti-HBs seroconversion and treatment duration after initial HBsAg loss were not. Risk of HBsAg seroreversion was observed to be lower if HBsAg loss was sustained through the off-treatment week 24 visit (8/10 seroreversions occurred by posttreatment week 24). Conclusion: HBsAg loss after NUC or Peg-IFN-containing regimens was durable in 82% of patients with CHB. Anti-HBs seroconversion and treatment duration after initial HBsAg loss were not significantly associated with durability of HBsAg loss. © 2019 The Authors. Hepatology Communications published by Wiley Periodicals, Inc., on behalf of the American Association for the Study of Liver Diseases.
Authors & Co-Authors
Lok, Anna Suk Fong
United States, Ann Arbor
University of Michigan, Ann Arbor
Zoulim, Fabien
France, Lyon
Centre de Recherche en Cancérologie de Lyon
Dusheiko, Geoffrey M.
United Kingdom, London
King's College Hospital
Chan, Henry Lik Yuen
Hong Kong, Hong Kong
Chinese University of Hong Kong
Butí, María Asunción
Spain, Barcelona
Hospital Universitari Vall D'hebron
Gaggar, Anuj
United States, Foster City
Gilead Sciences Incorporated
Yang, Jenny C.
United States, Foster City
Gilead Sciences Incorporated
Locarnini, Stephen A.
Australia
Victorian Infectious Diseases Reference Laboratory
Marcellin, Patrick M.
France, Clichy
Hôpital Beaujon
Statistics
Citations: 33
Authors: 9
Affiliations: 9
Identifiers
Doi:
10.1002/hep4.1436
ISSN:
2471254X
Research Areas
Infectious Diseases
Study Design
Cohort Study
Study Approach
Qualitative