Pretreatment serum HBsAg-to-HBV DNA ratio predicts a virologic response to entecavir in chronic hepatitis B.
10.3350/kjhep.2011.17.4.268
- Author:
Joon Chang SONG
1
;
Bo Young MIN
;
Jin Wook KIM
;
Jong Yeop KIM
;
Yeo Myeong KIM
;
Cheol Min SHIN
;
Sang Hyub LEE
;
Jin Hyeok HWANG
;
Sook Hyang JEONG
;
Nayoung KIM
;
Dong Ho LEE
Author Information
1. Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. kimw@snubh.org
- Publication Type:Original Article
- Keywords:
HBsAg;
Entecavir;
Virologic response
- MeSH:
Adult;
Aged;
Alanine Transaminase/blood;
Antiviral Agents/*therapeutic use;
Area Under Curve;
DNA, Viral/*blood;
Female;
Follow-Up Studies;
Guanine/*analogs & derivatives/therapeutic use;
Hepatitis B Surface Antigens/*blood;
Hepatitis B e Antigens/blood;
Hepatitis B virus/genetics;
Hepatitis B, Chronic/*drug therapy;
Humans;
Male;
Middle Aged;
ROC Curve
- From:The Korean Journal of Hepatology
2011;17(4):268-273
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Decay of hepatitis B surface antigen (HBsAg) titers has previously been shown to be predictive of a virologic response (VR), especially during peginterferon-alpha therapy. However, the role of HBsAg levels in predicting a VR to nucleos(t)ide analog therapy has not yet been established. In this study we sought to determine whether the VR can be predicted from HBsAg titers in nucleos(t)ide-naive chronic hepatitis B (CHB) patients treated with entecavir. METHODS: CHB patients who started entecavir as an initial antiviral therapy were enrolled in this study. Serum hepatitis B virus (HBV) DNA, HBsAg, and alanine aminotransferase levels were measured every 3 months during treatment. A VR was defined as undetectable serum HBV DNA titer by real-time PCR assay (<60 IU/mL). RESULTS: Fifty-two patients were enrolled, and the median duration of treatment was 26 months (range 7-35 months). Forty-five patients achieved a VR; the cumulative VR rates at 3, 6, 12, and 24 months were 40%, 71.2%, 81.5%, and 88%, respectively. Baseline HBV DNA levels were significantly lower in patients with VR, whereas the HBsAg levels did not differ significantly between patients with or without VR. In a univariate analysis the cumulative VR rate was significantly higher in HBeAg negative patients and patients with an HBsAg/HBV DNA ratio above 0.56. However, in a multivariate analysis only an HBsAg/HBV DNA ratio above 0.56 was an independent predictor of VR (P=0.003). The area under the receiver operating characteristic curve was larger for the HBsAg/HBV DNA ratio than for either HBV DNA or HBsAg. CONCLUSIONS: Pretreatment HBsAg/HBV DNA ratio can predict a long-term VR to entecavir therapy in nucleos(t)ide-naive CHB patients.
