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Article: Hepatitis B virus DNA levels at week 4 of lamivudine treatment predict the 5-year ideal response

TitleHepatitis B virus DNA levels at week 4 of lamivudine treatment predict the 5-year ideal response
Authors
Issue Date2007
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.hepatology.org/
Citation
Hepatology, 2007, v. 46 n. 6, p. 1695-1703 How to Cite?
AbstractThe best time and hepatitis B virus (HBV) DNA level during an early lamivudine treatment period for predicting the long-term outcome are unknown. We aimed to determine the optimal time and HBV DNA level during an early treatment period for the prediction of the response after a 5-year lamivudine treatment. The HBV DNA levels at the baseline, at weeks 2, 4, 8, 12, 16, 24, and 32, and at yearly intervals until year 5 were measured in 74 hepatitis B e antigen (HBeAg)-positive chronic HBV patients receiving lamivudine treatment. Seventeen patients achieved an ideal response [HBV DNA level < 2000 copies/mL (400 IU/mL), HBeAg seroconversion, normal alanine aminotransferase levels, and absence of tyrosine-methionine-aspartate-aspartate (YMDD) mutations] at year 5. Receiver operating characteristic curves showed good predictions as early as week 4. The areas under the curve for weeks 4 and 16 were 0.89 and 0.94, respectively. Predictive indices revealed 4 and 3.6 log copies/mL (2000 and 800 IU/mL, respectively) to be the best cutoff HBV DNA levels for these 2 times, respectively. All patients with HBV DNA levels lower than these respective cutoff levels at the 2 times achieved an ideal response at year 5. Patients with HBV DNA levels above these cutoff values had 83.8% and 87.7% chances of not achieving an ideal response at year 5, respectively. Conclusion: The measurement of the HBV DNA levels at week 4 of lamivudine treatment should be performed in all patients to predict the long-term outcome. The treatment can be continued for those with HBV DNA levels of less than 4 log copies/mL (2000 IU/mL). The addition of or switch to alternative antiviral agents should be considered for patients who fail to achieve this early target. Copyright © 2007 by the American Association for the Study of Liver Diseases.
Persistent Identifierhttp://hdl.handle.net/10722/77616
ISSN
2023 Impact Factor: 12.9
2023 SCImago Journal Rankings: 5.011
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorYuen, MFen_HK
dc.contributor.authorFong, DYTen_HK
dc.contributor.authorWong, DKHen_HK
dc.contributor.authorYuen, JCHen_HK
dc.contributor.authorFung, Jen_HK
dc.contributor.authorLai, CLen_HK
dc.date.accessioned2010-09-06T07:33:50Z-
dc.date.available2010-09-06T07:33:50Z-
dc.date.issued2007en_HK
dc.identifier.citationHepatology, 2007, v. 46 n. 6, p. 1695-1703en_HK
dc.identifier.issn0270-9139en_HK
dc.identifier.urihttp://hdl.handle.net/10722/77616-
dc.description.abstractThe best time and hepatitis B virus (HBV) DNA level during an early lamivudine treatment period for predicting the long-term outcome are unknown. We aimed to determine the optimal time and HBV DNA level during an early treatment period for the prediction of the response after a 5-year lamivudine treatment. The HBV DNA levels at the baseline, at weeks 2, 4, 8, 12, 16, 24, and 32, and at yearly intervals until year 5 were measured in 74 hepatitis B e antigen (HBeAg)-positive chronic HBV patients receiving lamivudine treatment. Seventeen patients achieved an ideal response [HBV DNA level < 2000 copies/mL (400 IU/mL), HBeAg seroconversion, normal alanine aminotransferase levels, and absence of tyrosine-methionine-aspartate-aspartate (YMDD) mutations] at year 5. Receiver operating characteristic curves showed good predictions as early as week 4. The areas under the curve for weeks 4 and 16 were 0.89 and 0.94, respectively. Predictive indices revealed 4 and 3.6 log copies/mL (2000 and 800 IU/mL, respectively) to be the best cutoff HBV DNA levels for these 2 times, respectively. All patients with HBV DNA levels lower than these respective cutoff levels at the 2 times achieved an ideal response at year 5. Patients with HBV DNA levels above these cutoff values had 83.8% and 87.7% chances of not achieving an ideal response at year 5, respectively. Conclusion: The measurement of the HBV DNA levels at week 4 of lamivudine treatment should be performed in all patients to predict the long-term outcome. The treatment can be continued for those with HBV DNA levels of less than 4 log copies/mL (2000 IU/mL). The addition of or switch to alternative antiviral agents should be considered for patients who fail to achieve this early target. Copyright © 2007 by the American Association for the Study of Liver Diseases.en_HK
dc.languageengen_HK
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.hepatology.org/en_HK
dc.relation.ispartofHepatologyen_HK
dc.rightsHepatology. Copyright © John Wiley & Sons, Inc.en_HK
dc.subject.meshAdolescenten_HK
dc.subject.meshAdulten_HK
dc.subject.meshAntiviral Agents - therapeutic useen_HK
dc.subject.meshDNA, Viral - blooden_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHepatitis B virusen_HK
dc.subject.meshHepatitis B, Chronic - blood - drug therapyen_HK
dc.subject.meshHumansen_HK
dc.subject.meshLamivudine - therapeutic useen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshPredictive Value of Testsen_HK
dc.subject.meshTreatment Outcomeen_HK
dc.subject.meshViral Loaden_HK
dc.titleHepatitis B virus DNA levels at week 4 of lamivudine treatment predict the 5-year ideal responseen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0270-9139&volume=46&spage=1695&epage=1703&date=2007&atitle=Hepatitis+B+virus+DNA+levels+at+week+4+of+lamivudine+treatment+predict+the+5-year+ideal+responseen_HK
dc.identifier.emailYuen, MF: mfyuen@hku.hken_HK
dc.identifier.emailFong, DYT: dytfong@hku.hken_HK
dc.identifier.emailWong, DKH: danywong@hku.hken_HK
dc.identifier.emailFung, J: jfung@sicklehut.comen_HK
dc.identifier.emailLai, CL: hrmelcl@hku.hken_HK
dc.identifier.authorityYuen, MF=rp00479en_HK
dc.identifier.authorityFong, DYT=rp00253en_HK
dc.identifier.authorityWong, DKH=rp00492en_HK
dc.identifier.authorityFung, J=rp00518en_HK
dc.identifier.authorityLai, CL=rp00314en_HK
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1002/hep.21939en_HK
dc.identifier.pmid18027877-
dc.identifier.scopuseid_2-s2.0-37749021636en_HK
dc.identifier.hkuros144479en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-37749021636&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume46en_HK
dc.identifier.issue6en_HK
dc.identifier.spage1695en_HK
dc.identifier.epage1703en_HK
dc.identifier.isiWOS:000251471700007-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridYuen, MF=7102031955en_HK
dc.identifier.scopusauthoridFong, DYT=35261710300en_HK
dc.identifier.scopusauthoridWong, DKH=7401535819en_HK
dc.identifier.scopusauthoridYuen, JCH=7102620480en_HK
dc.identifier.scopusauthoridFung, J=23091109300en_HK
dc.identifier.scopusauthoridLai, CL=7403086396en_HK
dc.identifier.issnl0270-9139-

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