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Conference Paper: Prediction of sustained response after nucleo(s)tide analogue cessation using HBsAg and HBcrAg levels – a multicenter study (CREATE)

TitlePrediction of sustained response after nucleo(s)tide analogue cessation using HBsAg and HBcrAg levels – a multicenter study (CREATE)
Authors
Issue Date2020
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.hepatology.org/
Citation
The Annual Meeting of the American Association for the Study of Liver Diseases (AASLD): The Liver Meeting Digital Experience 2020, Boston, USA, 13-16 November 2020. In Hepatology, 2020, v. 72 n. S1, p. 492A-493A, abstract no. 806 How to Cite?
AbstractBackground: Predictors of successful nucleo(s)tide analogue (NA) therapy withdrawal remain elusive. We studied the relationship between end-of-treatment levels of hepatitis B core related antigen (HBcrAg) and surface antigen (HBsAg) and outcome after therapy cessation. Methods: HBeAg-negative patients with undetectable HBV DNA who discontinued NA therapy in centers in Asia and Europe were enrolled. HBcrAg and HBsAg were measured at treatment cessation, and associations with off-treatment outcomes were explored. SCALE-B score (comprising HBcrAg, HBsAg, ALT, age and tenofovir use) was calculated as previously reported. Endpoints included sustained virological response (VR, HBV DNA<2,000 IU/mL), HBsAg loss and ALT flares (>3x ULN). Re-treated patients were considered non-responders. Results: We analysed 572 patients, 457 (80%) were Asian and 95 (17%) were HBeAg positive at start of NA therapy. The median treatment duration was 295 weeks. VR was observed in 267 (47%), HBsAg loss in 24 (4.2%) and ALT flare in 92 (16%) patients. VR (67% versus 42%) and HBsAg loss (15% versus 1.5%) was more frequently observed in non-Asian patients (p<0.001). Lower HBcrAg levels were associated with higher rates of VR (OR 0.701, p<0.001) and HBsAg loss (OR 0.476, p<0.001) and lower rates of ALT flares (OR 1.288, p=0.005). Similar results were observed with HBsAg (VR: OR 0.812, p=0.011; HBsAg loss: OR 0.380, p<0.001; ALT flare: OR 1.833, p<0.001). Lower SCALE-B scores were associated with higher rates of VR, HBsAg loss and lower rates of ALT flares in both Asian and non-Asian patients(p<0.001, figure). Conclusion: In this multicenter study, off-treatment outcomes after NA cessation varied with ethnicity. Lower levels of HBcrAg and HBsAg were associated with favourable outcomes. A risk score comprising both factors (SCALE-B) can be used for risk stratification.
DescriptionPoster presentation - no. 806
Persistent Identifierhttp://hdl.handle.net/10722/305534
ISSN
2023 Impact Factor: 12.9
2023 SCImago Journal Rankings: 5.011
AwardAASLD Foundation Abstract Award Recipient

 

DC FieldValueLanguage
dc.contributor.authorSonneveld, MJ-
dc.contributor.authorPark, JY-
dc.contributor.authorKaewdech, A-
dc.contributor.authorSeto, WKW-
dc.contributor.authorTanaka, Y-
dc.contributor.authorCarey, I-
dc.contributor.authorPapatheodoridi, M-
dc.contributor.authorVan Bömmel, F-
dc.contributor.authorBerg, T-
dc.contributor.authorZoulim, F-
dc.contributor.authorAhn, SH-
dc.contributor.authorDalekos, GN-
dc.contributor.authorErier, NS-
dc.contributor.authorHöner zu SiederdissenC, C-
dc.contributor.authorWedemeyer, H-
dc.contributor.authorComberg, M-
dc.contributor.authorYuen, RMF-
dc.contributor.authorAgarwal, K-
dc.contributor.authorBoonstra, A-
dc.contributor.authorFerret, MAB-
dc.contributor.authorPiratvisuth, T-
dc.contributor.authorPapatheodoridis, G-
dc.contributor.authorMaasoumy, B-
dc.contributor.authorCREATE study group,-
dc.date.accessioned2021-10-20T10:10:45Z-
dc.date.available2021-10-20T10:10:45Z-
dc.date.issued2020-
dc.identifier.citationThe Annual Meeting of the American Association for the Study of Liver Diseases (AASLD): The Liver Meeting Digital Experience 2020, Boston, USA, 13-16 November 2020. In Hepatology, 2020, v. 72 n. S1, p. 492A-493A, abstract no. 806-
dc.identifier.issn0270-9139-
dc.identifier.urihttp://hdl.handle.net/10722/305534-
dc.descriptionPoster presentation - no. 806-
dc.description.abstractBackground: Predictors of successful nucleo(s)tide analogue (NA) therapy withdrawal remain elusive. We studied the relationship between end-of-treatment levels of hepatitis B core related antigen (HBcrAg) and surface antigen (HBsAg) and outcome after therapy cessation. Methods: HBeAg-negative patients with undetectable HBV DNA who discontinued NA therapy in centers in Asia and Europe were enrolled. HBcrAg and HBsAg were measured at treatment cessation, and associations with off-treatment outcomes were explored. SCALE-B score (comprising HBcrAg, HBsAg, ALT, age and tenofovir use) was calculated as previously reported. Endpoints included sustained virological response (VR, HBV DNA<2,000 IU/mL), HBsAg loss and ALT flares (>3x ULN). Re-treated patients were considered non-responders. Results: We analysed 572 patients, 457 (80%) were Asian and 95 (17%) were HBeAg positive at start of NA therapy. The median treatment duration was 295 weeks. VR was observed in 267 (47%), HBsAg loss in 24 (4.2%) and ALT flare in 92 (16%) patients. VR (67% versus 42%) and HBsAg loss (15% versus 1.5%) was more frequently observed in non-Asian patients (p<0.001). Lower HBcrAg levels were associated with higher rates of VR (OR 0.701, p<0.001) and HBsAg loss (OR 0.476, p<0.001) and lower rates of ALT flares (OR 1.288, p=0.005). Similar results were observed with HBsAg (VR: OR 0.812, p=0.011; HBsAg loss: OR 0.380, p<0.001; ALT flare: OR 1.833, p<0.001). Lower SCALE-B scores were associated with higher rates of VR, HBsAg loss and lower rates of ALT flares in both Asian and non-Asian patients(p<0.001, figure). Conclusion: In this multicenter study, off-treatment outcomes after NA cessation varied with ethnicity. Lower levels of HBcrAg and HBsAg were associated with favourable outcomes. A risk score comprising both factors (SCALE-B) can be used for risk stratification.-
dc.languageeng-
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.hepatology.org/-
dc.relation.ispartofHepatology-
dc.relation.ispartofThe Annual Meeting of the American Association for the Study of Liver Diseases (AASLD): The Liver Meeting Digital Experience 2020-
dc.titlePrediction of sustained response after nucleo(s)tide analogue cessation using HBsAg and HBcrAg levels – a multicenter study (CREATE)-
dc.typeConference_Paper-
dc.identifier.emailSeto, WKW: wkseto@hku.hk-
dc.identifier.emailYuen, RMF: mfyuen@hku.hk-
dc.identifier.authoritySeto, WKW=rp01659-
dc.identifier.authorityYuen, RMF=rp00479-
dc.description.natureabstract-
dc.identifier.hkuros326983-
dc.identifier.volume72-
dc.identifier.issueS1-
dc.identifier.spage492A-
dc.identifier.epage493A-
dc.publisher.placeUnited States-
dc.description.awardAASLD Foundation Abstract Award Recipient-
dc.identifier.partofdoi10.1002/hep.31579-

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