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Article: Profiles of HBV DNA in a large population of Chinese patients with chronic hepatitis B: Implications for antiviral therapy

TitleProfiles of HBV DNA in a large population of Chinese patients with chronic hepatitis B: Implications for antiviral therapy
Authors
KeywordsAntiviral therapy
Chronic hepatitis B
HBV DNA
Treatment guidelines
Viral load
Issue Date2011
PublisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/jhep
Citation
Journal Of Hepatology, 2011, v. 54 n. 2, p. 195-200 How to Cite?
Abstract
Background & Aims: We determined the virological profile in Chinese chronic hepatitis B (CHB) subjects and its implications regarding current treatment guidelines. Methods: A total of 1400 treatment-naïve CHB patients had their HBV DNA levels determined using the Cobas Taqman assay. Patient demographics, HBeAg status, and liver biochemistry were also recorded. Results: The subjects were predominantly male (62%), had a median age of 45 years, and 301 (22%) were HBeAg-positive. In subjects aged ≤25, 26-35, 36-45, 46-55, and >55 years, there was a decreasing trend of HBV DNA levels of 9.9, 9.3, 8.2, 7.4, and 7.3 log copies/ml, respectively (p <0.001), in HBeAg-positive subjects, while the pattern was reversed with HBV DNA levels of 3.7, 4.4, 4.7, 4.9, and 5.2 log copies/ml, respectively, in HBeAg-negative subjects (p <0.001). In HBeAg-negative subjects, the proportion of patients with elevated ALT compared to those with normal ALT was significantly higher in older age groups (p <0.001). In our study population, by applying the AASLD, EASL, and APASL guidelines, 64%, 99%, and 64% would be eligible for antiviral therapy, respectively, in HBeAg-positive patients (with elevated ALT), and 38%, 72%, and 43%, respectively, in HBeAg-negative patients (with elevated ALT). Up to 54% of patients over the age of 40 years would be recommended for liver biopsy to determine further eligibility for treatment. Conclusions: For HBeAg-negative CHB, more patients had elevated ALT and a higher viral load with increasing age. Close monitoring is recommended in this group so that treatment may be considered. By applying the current treatment guidelines, a wide discrepancy can be observed in the proportion of patients eligible for treatment in the absence of histological data. © 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/139478
ISSN
2013 Impact Factor: 10.401
ISI Accession Number ID
Funding AgencyGrant Number
Bristol-Myer-Squibb
Funding Information:

This study has been generously supported by an unrestricted grant from Bristol-Myer-Squibb.

References

 

Author Affiliations
  1. The University of Hong Kong
DC FieldValueLanguage
dc.contributor.authorFung, Jen_HK
dc.contributor.authorSeto, WKen_HK
dc.contributor.authorLai, CLen_HK
dc.contributor.authorYuen, Jen_HK
dc.contributor.authorWong, DKHen_HK
dc.contributor.authorYuen, MFen_HK
dc.date.accessioned2011-09-23T05:50:30Z-
dc.date.available2011-09-23T05:50:30Z-
dc.date.issued2011en_HK
dc.identifier.citationJournal Of Hepatology, 2011, v. 54 n. 2, p. 195-200en_HK
dc.identifier.issn0168-8278en_HK
dc.identifier.urihttp://hdl.handle.net/10722/139478-
dc.description.abstractBackground & Aims: We determined the virological profile in Chinese chronic hepatitis B (CHB) subjects and its implications regarding current treatment guidelines. Methods: A total of 1400 treatment-naïve CHB patients had their HBV DNA levels determined using the Cobas Taqman assay. Patient demographics, HBeAg status, and liver biochemistry were also recorded. Results: The subjects were predominantly male (62%), had a median age of 45 years, and 301 (22%) were HBeAg-positive. In subjects aged ≤25, 26-35, 36-45, 46-55, and >55 years, there was a decreasing trend of HBV DNA levels of 9.9, 9.3, 8.2, 7.4, and 7.3 log copies/ml, respectively (p <0.001), in HBeAg-positive subjects, while the pattern was reversed with HBV DNA levels of 3.7, 4.4, 4.7, 4.9, and 5.2 log copies/ml, respectively, in HBeAg-negative subjects (p <0.001). In HBeAg-negative subjects, the proportion of patients with elevated ALT compared to those with normal ALT was significantly higher in older age groups (p <0.001). In our study population, by applying the AASLD, EASL, and APASL guidelines, 64%, 99%, and 64% would be eligible for antiviral therapy, respectively, in HBeAg-positive patients (with elevated ALT), and 38%, 72%, and 43%, respectively, in HBeAg-negative patients (with elevated ALT). Up to 54% of patients over the age of 40 years would be recommended for liver biopsy to determine further eligibility for treatment. Conclusions: For HBeAg-negative CHB, more patients had elevated ALT and a higher viral load with increasing age. Close monitoring is recommended in this group so that treatment may be considered. By applying the current treatment guidelines, a wide discrepancy can be observed in the proportion of patients eligible for treatment in the absence of histological data. © 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.en_HK
dc.languageengen_US
dc.publisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/jhepen_HK
dc.relation.ispartofJournal of Hepatologyen_HK
dc.subjectAntiviral therapyen_HK
dc.subjectChronic hepatitis Ben_HK
dc.subjectHBV DNAen_HK
dc.subjectTreatment guidelinesen_HK
dc.subjectViral loaden_HK
dc.subject.meshAlanine Transaminase - blood-
dc.subject.meshDNA, Viral - analysis-
dc.subject.meshHepatitis B virus - genetics - isolation and purification-
dc.subject.meshHepatitis B, Chronic - drug therapy - virology-
dc.subject.meshViral Load-
dc.titleProfiles of HBV DNA in a large population of Chinese patients with chronic hepatitis B: Implications for antiviral therapyen_HK
dc.typeArticleen_HK
dc.identifier.emailFung, J: jfung@sicklehut.comen_HK
dc.identifier.emailSeto, WK: wkseto2@hku.hken_HK
dc.identifier.emailLai, CL: hrmelcl@hku.hken_HK
dc.identifier.emailWong, DKH: danywong@hku.hken_HK
dc.identifier.emailYuen, MF: mfyuen@hku.hken_HK
dc.identifier.authorityFung, J=rp00518en_HK
dc.identifier.authoritySeto, WK=rp01659en_HK
dc.identifier.authorityLai, CL=rp00314en_HK
dc.identifier.authorityWong, DKH=rp00492en_HK
dc.identifier.authorityYuen, MF=rp00479en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.jhep.2010.06.031en_HK
dc.identifier.pmid21056499en_HK
dc.identifier.scopuseid_2-s2.0-78751578866en_HK
dc.identifier.hkuros195206en_US
dc.identifier.hkuros189852-
dc.identifier.hkuros213684-
dc.identifier.hkuros213684-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-78751578866&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume54en_HK
dc.identifier.issue2en_HK
dc.identifier.spage195en_HK
dc.identifier.epage200en_HK
dc.identifier.isiWOS:000287070400004-
dc.publisher.placeNetherlandsen_HK
dc.identifier.scopusauthoridFung, J=23091109300en_HK
dc.identifier.scopusauthoridSeto, WK=23390675900en_HK
dc.identifier.scopusauthoridLai, CL=7403086396en_HK
dc.identifier.scopusauthoridYuen, J=7102620480en_HK
dc.identifier.scopusauthoridWong, DKH=7401535819en_HK
dc.identifier.scopusauthoridYuen, MF=7102031955en_HK
dc.identifier.citeulike7836287-

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