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Article: Incidences and Determinants of Functional Cure during Entecavir or Tenofovir Disoproxil Fumarate for Chronic Hepatitis B

TitleIncidences and Determinants of Functional Cure during Entecavir or Tenofovir Disoproxil Fumarate for Chronic Hepatitis B
Authors
KeywordsHepatitis B virus
Functional cure
Entecavir
Tenofovir
Hepatitis B surface antigens
REAL-B
Issue Date2021
PublisherOxford University Press. The Journal's web site is located at http://jid.oxfordjournals.org
Citation
The Journal of Infectious Diseases, 2021, v. 224 n. 11, p. 1890-1899 How to Cite?
AbstractBackground: Long-term incidences and baseline determinants of functional cure (hepatitis B surface antigen [HBsAg] seroclearance) during entecavir (ETV) or tenofovir disoproxil fumarate (TDF) treatment are incompletely understood. Methods: This is an international multicenter cohort study of treatment-naive patients with chronic hepatitis B who started ETV or TDF treatment without baseline cancer. Patients were observed for HBsAg seroclearance until death or loss to follow-up. We calculated the incidences and explored the baseline determinants of HBsAg seroclearance using competing risk regression. Results: The analysis included 4769 patients (median age, 50 years; 69.05% male), with a median follow-up of 5.16 years (26 614.47 person-years). HBsAg clearance occurred in 58 patients, yielding a 10-year cumulative incidence of 2.11% (95% confidence interval, 1.54%–2.88%) and an annual rate of 0.22% (.17%–.28%). Baseline predictors included low-level viremia with hepatitis B virus DNA <2000 IU/mL (adjusted subdistribution hazard ratio, 3.14 [95% confidence interval, 1.80–5.49]), elevated serum alanine aminotransferase >200 U/L (3.68 [2.07–6.53]), serum bilirubin (1.11 per mg/dL; [1.06–1.17 mg/dL]), and fatty liver (1.84 [1.03–3.29]). Conclusion: HBsAg seroclearance rarely occurs in patients with chronic hepatitis B treated with ETV or TDF and is associated with low-level viremia, alanine aminotransferase flare, bilirubin level, and fatty liver. Functional cure of hepatitis B virus infection rarely occurred at an average annual rate of 0.22% during first-line oral antiviral treatment, with higher chances observed in patients with low-level viremia, high-level aminotransferase flare, elevation of serum bilirubin, and fatty liver.
Persistent Identifierhttp://hdl.handle.net/10722/300545
ISSN
2023 Impact Factor: 5.0
2023 SCImago Journal Rankings: 2.387
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorHsu, YC-
dc.contributor.authorYeh, ML-
dc.contributor.authorWong, GLH-
dc.contributor.authorChen, CH-
dc.contributor.authorPeng, CY-
dc.contributor.authorButi, M-
dc.contributor.authorEnomoto, M-
dc.contributor.authorXie, Q-
dc.contributor.authorTrinh, H-
dc.contributor.authorPreda, C-
dc.contributor.authorLiu, L-
dc.contributor.authorCheung, KS-
dc.contributor.authorYeo, YH-
dc.contributor.authorHoang, J-
dc.contributor.authorHuang, CF-
dc.contributor.authorRiveiro-Barciela, M-
dc.contributor.authorKozuka, R-
dc.contributor.authorIstratescu, D-
dc.contributor.authorTsai, PC-
dc.contributor.authorAccarino, EV-
dc.contributor.authorLee, DH-
dc.contributor.authorWu, JL-
dc.contributor.authorHuang, JF-
dc.contributor.authorDai, CY-
dc.contributor.authorCheung, R-
dc.contributor.authorChuang, WL-
dc.contributor.authorYuen, MF-
dc.contributor.authorWong, VWS-
dc.contributor.authorYu, ML-
dc.contributor.authorNguyen, MH-
dc.date.accessioned2021-06-18T14:53:30Z-
dc.date.available2021-06-18T14:53:30Z-
dc.date.issued2021-
dc.identifier.citationThe Journal of Infectious Diseases, 2021, v. 224 n. 11, p. 1890-1899-
dc.identifier.issn0022-1899-
dc.identifier.urihttp://hdl.handle.net/10722/300545-
dc.description.abstractBackground: Long-term incidences and baseline determinants of functional cure (hepatitis B surface antigen [HBsAg] seroclearance) during entecavir (ETV) or tenofovir disoproxil fumarate (TDF) treatment are incompletely understood. Methods: This is an international multicenter cohort study of treatment-naive patients with chronic hepatitis B who started ETV or TDF treatment without baseline cancer. Patients were observed for HBsAg seroclearance until death or loss to follow-up. We calculated the incidences and explored the baseline determinants of HBsAg seroclearance using competing risk regression. Results: The analysis included 4769 patients (median age, 50 years; 69.05% male), with a median follow-up of 5.16 years (26 614.47 person-years). HBsAg clearance occurred in 58 patients, yielding a 10-year cumulative incidence of 2.11% (95% confidence interval, 1.54%–2.88%) and an annual rate of 0.22% (.17%–.28%). Baseline predictors included low-level viremia with hepatitis B virus DNA <2000 IU/mL (adjusted subdistribution hazard ratio, 3.14 [95% confidence interval, 1.80–5.49]), elevated serum alanine aminotransferase >200 U/L (3.68 [2.07–6.53]), serum bilirubin (1.11 per mg/dL; [1.06–1.17 mg/dL]), and fatty liver (1.84 [1.03–3.29]). Conclusion: HBsAg seroclearance rarely occurs in patients with chronic hepatitis B treated with ETV or TDF and is associated with low-level viremia, alanine aminotransferase flare, bilirubin level, and fatty liver. Functional cure of hepatitis B virus infection rarely occurred at an average annual rate of 0.22% during first-line oral antiviral treatment, with higher chances observed in patients with low-level viremia, high-level aminotransferase flare, elevation of serum bilirubin, and fatty liver.-
dc.languageeng-
dc.publisherOxford University Press. The Journal's web site is located at http://jid.oxfordjournals.org-
dc.relation.ispartofThe Journal of Infectious Diseases-
dc.subjectHepatitis B virus-
dc.subjectFunctional cure-
dc.subjectEntecavir-
dc.subjectTenofovir-
dc.subjectHepatitis B surface antigens-
dc.subjectREAL-B-
dc.titleIncidences and Determinants of Functional Cure during Entecavir or Tenofovir Disoproxil Fumarate for Chronic Hepatitis B-
dc.typeArticle-
dc.identifier.emailCheung, KS: cks634@hku.hk-
dc.identifier.emailYuen, MF: mfyuen@hku.hk-
dc.identifier.authorityCheung, KS=rp02532-
dc.identifier.authorityYuen, MF=rp00479-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1093/infdis/jiab241-
dc.identifier.pmid33999179-
dc.identifier.scopuseid_2-s2.0-85115255041-
dc.identifier.hkuros322877-
dc.identifier.volume224-
dc.identifier.issue11-
dc.identifier.spage1890-
dc.identifier.epage1899-
dc.identifier.isiWOS:000730267700009-
dc.publisher.placeUnited States-

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