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Article: Association of hepatitis B core-related antigen with hepatitis B virus reactivation in occult viral carriers undergoing high-risk immunosuppressive therapy

TitleAssociation of hepatitis B core-related antigen with hepatitis B virus reactivation in occult viral carriers undergoing high-risk immunosuppressive therapy
Authors
Issue Date2016
PublisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ajg/index.html
Citation
American Journal of Gastroenterology, 2016, v. 111 n. 12, p. 1788-1795 How to Cite?
AbstractOBJECTIVES: Hepatitis B core-related antigen (HBcrAg) is a novel serum marker that correlates with intrahepatic hepatitis B virus (HBV) activity. Its association with HBV reactivation in hepatitis B surface antigen (HBsAg)-negative antibody to hepatitis B core antigen (anti-HBc)-positive patients undergoing high-risk immunosuppressive therapy is undefined. METHODS: HBcrAg was measured in HBsAg-negative, anti-HBc-positive Asian patients with undetectable HBV DNA, who participated in two prospective studies investigating HBV reactivation during rituximab-containing chemotherapy and allogeneic hematopoietic stem cell transplantation (HSCT). Patients were monitored every 4 weeks for up to 2 years, with entecavir started when HBV reactivation, defined as HBV DNA ≥10 IU ml−1, developed. RESULTS: One hundred and twenty-four HBsAg-negative, anti-HBc-positive patients (rituximab, N =62; allogeneic HSCT, N =62) with a median follow-up of 64 weeks (range: 4–104 weeks) were studied. HBV reactivation occurred in 31 patients, with a 2-year cumulative reactivation rate of 40.4%. Serum HBcrAg was detected in 43 (34.7%) patients. Baseline HBcrAg positivity was significantly associated with HBV reactivation ( P =0.004, hazard ratio (HR): 2.94, 95% confidence interval (95% CI): 1.43–6.07). HBcrAg-positive patients had a significantly higher 2-year HBV reactivation rate than HBcrAg-negative patients (71.8 vs. 31%, P =0.002). In the rituximab cohort, the HRs for positive HBcrAg and negative antibody to HBsAg for HBV reactivation were 3.65 and 2.84, respectively ( P =0.011, 95% CI: 1.35–9.86 and P =0.032, 95% CI: 1.10–7.37, respectively). CONCLUSIONS: Serum HBcrAg positivity is a significant risk factor of HBV reactivation in HBsAg-negative, anti-HBc-positive patients undergoing high-risk immunosuppressive therapy and can potentially have a role in identifying patients who will best benefit from prophylactic nucleoside analogue treatment.
Persistent Identifierhttp://hdl.handle.net/10722/232077
ISSN
2017 Impact Factor: 10.231
2015 SCImago Journal Rankings: 3.946
ISI Accession Number ID
Errata

 

DC FieldValueLanguage
dc.contributor.authorSeto, WKW-
dc.contributor.authorWong, DKH-
dc.contributor.authorChan, SYT-
dc.contributor.authorHwang, YYG-
dc.contributor.authorFung, JYY-
dc.contributor.authorLiu, SHK-
dc.contributor.authorSingh, GHH-
dc.contributor.authorLam, YF-
dc.contributor.authorCheung, KSM-
dc.contributor.authorLie, AKW-
dc.contributor.authorLai, CL-
dc.contributor.authorKwong, YL-
dc.contributor.authorYuen, RMF-
dc.date.accessioned2016-09-20T05:27:33Z-
dc.date.available2016-09-20T05:27:33Z-
dc.date.issued2016-
dc.identifier.citationAmerican Journal of Gastroenterology, 2016, v. 111 n. 12, p. 1788-1795-
dc.identifier.issn0002-9270-
dc.identifier.urihttp://hdl.handle.net/10722/232077-
dc.description.abstractOBJECTIVES: Hepatitis B core-related antigen (HBcrAg) is a novel serum marker that correlates with intrahepatic hepatitis B virus (HBV) activity. Its association with HBV reactivation in hepatitis B surface antigen (HBsAg)-negative antibody to hepatitis B core antigen (anti-HBc)-positive patients undergoing high-risk immunosuppressive therapy is undefined. METHODS: HBcrAg was measured in HBsAg-negative, anti-HBc-positive Asian patients with undetectable HBV DNA, who participated in two prospective studies investigating HBV reactivation during rituximab-containing chemotherapy and allogeneic hematopoietic stem cell transplantation (HSCT). Patients were monitored every 4 weeks for up to 2 years, with entecavir started when HBV reactivation, defined as HBV DNA ≥10 IU ml−1, developed. RESULTS: One hundred and twenty-four HBsAg-negative, anti-HBc-positive patients (rituximab, N =62; allogeneic HSCT, N =62) with a median follow-up of 64 weeks (range: 4–104 weeks) were studied. HBV reactivation occurred in 31 patients, with a 2-year cumulative reactivation rate of 40.4%. Serum HBcrAg was detected in 43 (34.7%) patients. Baseline HBcrAg positivity was significantly associated with HBV reactivation ( P =0.004, hazard ratio (HR): 2.94, 95% confidence interval (95% CI): 1.43–6.07). HBcrAg-positive patients had a significantly higher 2-year HBV reactivation rate than HBcrAg-negative patients (71.8 vs. 31%, P =0.002). In the rituximab cohort, the HRs for positive HBcrAg and negative antibody to HBsAg for HBV reactivation were 3.65 and 2.84, respectively ( P =0.011, 95% CI: 1.35–9.86 and P =0.032, 95% CI: 1.10–7.37, respectively). CONCLUSIONS: Serum HBcrAg positivity is a significant risk factor of HBV reactivation in HBsAg-negative, anti-HBc-positive patients undergoing high-risk immunosuppressive therapy and can potentially have a role in identifying patients who will best benefit from prophylactic nucleoside analogue treatment.-
dc.languageeng-
dc.publisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ajg/index.html-
dc.relation.ispartofAmerican Journal of Gastroenterology-
dc.titleAssociation of hepatitis B core-related antigen with hepatitis B virus reactivation in occult viral carriers undergoing high-risk immunosuppressive therapy-
dc.typeArticle-
dc.identifier.emailSeto, WKW: wkseto@hku.hk-
dc.identifier.emailWong, DKH: danywong@hku.hk-
dc.identifier.emailChan, SYT: drtchan@hku.hk-
dc.identifier.emailHwang, YYG: yyhwang@hku.hk-
dc.identifier.emailFung, JYY: jfung@hkucc.hku.hk-
dc.identifier.emailLiu, SHK: drkliu@hku.hk-
dc.identifier.emailSingh, GHH: gillhsh@hku.hk-
dc.identifier.emailLam, YF: fyflam@hku.hk-
dc.identifier.emailCheung, KSM: cks634@hku.hk-
dc.identifier.emailLie, AKW: akwlie@hkucc.hku.hk-
dc.identifier.emailLai, CL: hrmelcl@hkucc.hku.hk-
dc.identifier.emailKwong, YL: ylkwong@hkucc.hku.hk-
dc.identifier.emailYuen, RMF: mfyuen@hku.hk-
dc.identifier.authoritySeto, WKW=rp01659-
dc.identifier.authorityWong, DKH=rp00492-
dc.identifier.authorityFung, JYY=rp00518-
dc.identifier.authoritySingh, GHH=rp01914-
dc.identifier.authorityCheung, KSM=rp02532-
dc.identifier.authorityLai, CL=rp00314-
dc.identifier.authorityKwong, YL=rp00358-
dc.identifier.authorityYuen, RMF=rp00479-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1038/ajg.2016.436-
dc.identifier.pmid27644733-
dc.identifier.scopuseid_2-s2.0-84988569126-
dc.identifier.hkuros266801-
dc.identifier.hkuros304362-
dc.identifier.volume111-
dc.identifier.issue12-
dc.identifier.spage1788-
dc.identifier.epage1795-
dc.identifier.isiWOS:000394057300025-
dc.publisher.placeUnited States-
dc.relation.erratumdoi:10.1038/ajg.2016.510-
dc.relation.erratumeid:eid_2-s2.0-85003691671-

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