Article: Significance of HBV DNA levels at 12 weeks of telbivudine treatment and the 3 years treatment outcome

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TitleSignificance of HBV DNA levels at 12 weeks of telbivudine treatment and the 3 years treatment outcome
AuthorsSeto, WK1
Lai, CL1
Fung, J1
Wong, DKH1
Yuen, JCH1
Hung, IFN1
Yuen, MF1
Issue Date2011
PublisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/jhep
CitationJournal of Hepatology, 2011, v. 55 n. 3, p. 522-528 [How to Cite?]
DOI: http://dx.doi.org/10.1016/j.jhep.2010.11.018
AbstractBACKGROUND and AIMS: The significance of early HBV DNA suppression during telbivudine treatment in predicting long-term outcomes needs further investigation. METHODS: We determined the cumulative rates of HBeAg seroconversion, ALT normalization, HBV DNA suppression (<12IU/ml) and telbivudine resistant mutations (using the highly sensitive line probe assay) for 117 treatment-native chronic hepatitis B (CHB) patients (61.5% HBeAg-positive) on telbivudine for 3years. The significance of serum HBV DNA at week 12 and 24 was compared. RESULTS: The median age and duration of follow-up were 39years and 24.2months, respectively. 117, 105, 69, and 43 patients had been followed up for at least 6months and 1, 2, and 3years, respectively. The cumulative rates of HBeAg seroconversion, ALT normalization, HBV DNA undetectability were 46.8%, 80.5%, and 51.2%, respectively, at 3years. There was an incremental increase in virologic breakthroughs to 39.5% by year 3. The cumulative rate of telbivudine resistant mutations was 4.8%, 17.6%, and 34.0% for year 1, 2, and 3, respectively. Week 12 HBV DNA of <200IU/ml was predictive of a higher chance of HBV DNA undetectability (p=0.022) and lower chance of resistance (p=0.001) by year 3. Undetectable HBV DNA at week 24 was predictive of viral suppression at year 2 (p<0.001) but not at year 3 (p=0.241). CONCLUSIONS: Continuous telbivudine resulted in improved biochemical and virologic outcomes, although there was an incremental increase in cumulative rate of resistance up to year 3. Week 12 HBV DNA of <200IU/ml was predictive of favorable long-term outcomes.
ISSN0168-8278
2011 Impact Factor: 9.264
2011 SCImago Journal Rankings: 0.765
DOIhttp://dx.doi.org/10.1016/j.jhep.2010.11.018
ReferencesReferences in Scopus
DC Field
Value
dc.contributor.authorSeto, WK
dc.contributor.authorLai, CL
dc.contributor.authorFung, J
dc.contributor.authorWong, DKH
dc.contributor.authorYuen, JCH
dc.contributor.authorHung, IFN
dc.contributor.authorYuen, MF
dc.date.accessioned2011-08-26T14:24:12Z
dc.date.available2011-08-26T14:24:12Z
dc.date.issued2011
dc.description.abstractBACKGROUND and AIMS: The significance of early HBV DNA suppression during telbivudine treatment in predicting long-term outcomes needs further investigation. METHODS: We determined the cumulative rates of HBeAg seroconversion, ALT normalization, HBV DNA suppression (<12IU/ml) and telbivudine resistant mutations (using the highly sensitive line probe assay) for 117 treatment-native chronic hepatitis B (CHB) patients (61.5% HBeAg-positive) on telbivudine for 3years. The significance of serum HBV DNA at week 12 and 24 was compared. RESULTS: The median age and duration of follow-up were 39years and 24.2months, respectively. 117, 105, 69, and 43 patients had been followed up for at least 6months and 1, 2, and 3years, respectively. The cumulative rates of HBeAg seroconversion, ALT normalization, HBV DNA undetectability were 46.8%, 80.5%, and 51.2%, respectively, at 3years. There was an incremental increase in virologic breakthroughs to 39.5% by year 3. The cumulative rate of telbivudine resistant mutations was 4.8%, 17.6%, and 34.0% for year 1, 2, and 3, respectively. Week 12 HBV DNA of <200IU/ml was predictive of a higher chance of HBV DNA undetectability (p=0.022) and lower chance of resistance (p=0.001) by year 3. Undetectable HBV DNA at week 24 was predictive of viral suppression at year 2 (p<0.001) but not at year 3 (p=0.241). CONCLUSIONS: Continuous telbivudine resulted in improved biochemical and virologic outcomes, although there was an incremental increase in cumulative rate of resistance up to year 3. Week 12 HBV DNA of <200IU/ml was predictive of favorable long-term outcomes.
dc.description.naturelink_to_subscribed_fulltext
dc.identifier.citationJournal of Hepatology, 2011, v. 55 n. 3, p. 522-528 [How to Cite?]
DOI: http://dx.doi.org/10.1016/j.jhep.2010.11.018
dc.identifier.citeulike8451348
dc.identifier.doihttp://dx.doi.org/10.1016/j.jhep.2010.11.018
dc.identifier.epage528
dc.identifier.hkuros189850
dc.identifier.hkuros211251
dc.identifier.isiWOS:000293930600006
dc.identifier.issn0168-8278
2011 Impact Factor: 9.264
2011 SCImago Journal Rankings: 0.765
dc.identifier.issue3
dc.identifier.openurl
dc.identifier.pmid21147187
dc.identifier.scopuseid_2-s2.0-84860390069
dc.identifier.spage522
dc.identifier.urihttp://hdl.handle.net/10722/137383
dc.identifier.volume55
dc.languageeng
dc.publisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/jhep
dc.publisher.placeNetherlands
dc.relation.ispartofJournal of Hepatology
dc.relation.referencesReferences in Scopus
dc.subject.meshAntiviral Agents - therapeutic use
dc.subject.meshHepatitis B virus - genetics
dc.subject.meshHepatitis B, Chronic - blood - drug therapy - virology
dc.subject.meshNucleosides - pharmacology - therapeutic use
dc.subject.meshPyrimidinones - pharmacology - therapeutic use
dc.titleSignificance of HBV DNA levels at 12 weeks of telbivudine treatment and the 3 years treatment outcome
dc.typeArticle
Author Affiliations
  1. The University of Hong Kong