1.The factors associated with longitudinal changes in liver stiffness in patients with chronic hepatitis B.
In Ku YO ; Oh Sang KWON ; Jin Woong PARK ; Jong Joon LEE ; Jung Hyun LEE ; In Sik WON ; Sun Young NA ; Pil Kyu JANG ; Pyung Hwa PARK ; Duck Joo CHOI ; Yun Soo KIM ; Ju Hyun KIM
Clinical and Molecular Hepatology 2015;21(1):32-40
BACKGROUND/AIMS: Liver stiffness (LS) as assessed by transient elastography (TE) can change longitudinally in patients with chronic hepatitis B (CHB). The aim of this study was to identify the factors that improve LS. METHODS: Between April 2007 and December 2012, 151 patients with CHB who underwent two TE procedures with an interval of about 2 years were enrolled. Ninety-six of the 151 patients were treated with nucleos(t)ide analogues [the antiviral therapy (+) group], while the remaining 55 patients were not [the antiviral therapy (-) group]. The two groups of patients were stratified according to whether they exhibited an improvement or a deterioration in LS during the study period (defined as an LS change of < or =0 or >0 kPa, respectively, over a 1-year period), and their data were compared. RESULTS: No differences were observed between the antiviral therapy (+) and (-) groups with respect to either their clinical characteristics or their initial LS. The observed LS improvement was significantly greater in the antiviral therapy (+) group than in the antiviral therapy (-) group (-3.0 vs. 0.98 kPa, P=0.011). In the antiviral therapy (+) group, the initial LS was higher in the LS improvement group (n=63) than in the LS deterioration group (n=33; 7.9 vs. 4.8 kPa, P<0.001). However, there were no differences in any other clinical characteristic. In the antiviral therapy (-) group, the initial LS was also higher in the LS improvement group (n=29) than in the LS deterioration group (n=26; 8.3 vs. 6.5 kPa, P=0.021), with no differences in any other clinical characteristic. CONCLUSIONS: A higher initial LS was the only factor associated with LS improvement in patients with CHB in this study.
Adult
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Aged
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Alanine Transaminase/blood
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Antiviral Agents/therapeutic use
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DNA, Viral/blood
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Elasticity Imaging Techniques
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Female
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Hepatitis B e Antigens/blood
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Hepatitis B virus/genetics
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Hepatitis B, Chronic/drug therapy/pathology/*ultrasonography
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Humans
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Logistic Models
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Longitudinal Studies
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Male
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Middle Aged
2.Efficacy of prolonged entecavir monotherapy in treatment-naive chronic hepatitis B patients exhibiting a partial virologic response to entecavir.
Han Na CHOI ; Jeong Eun SONG ; Hyeon Chul LEE ; Hyeong Ho JO ; Chang Hyeong LEE ; Byung Seok KIM
Clinical and Molecular Hepatology 2015;21(1):24-31
BACKGROUND/AIMS: The optimal management of patients exhibiting a partial virologic response (PVR) to entecavir (ETV) has not been determined . The aim of this study was to determine the long-term efficacy of prolonged ETV monotherapy in treatment-naive chronic hepatitis B (CHB) patients exhibiting a PVR to ETV therapy. METHODS: This study included 364 treatment-naive CHB patients treated with ETV for > or =48 weeks and who received continuous ETV monotherapy for > or =96 weeks. PVR was defined as a decrease in serum hepatitis B virus (HBV) DNA of more than 2 log10 IU/mL from baseline but with detectable HBV DNA by real-time PCR assay at week 48. RESULTS: Fifty-two of the 364 patients (14.3%) showed a PVR. Among them, 41 patients received continuous ETV monotherapy for > or =96 weeks (median duration 144 weeks, range 96-312 weeks), and 40 of these patients (95%) achieved a virologic response (VR, HBV DNA <20 IU/mL) during prolonged ETV monotherapy (median duration 78 weeks, range 60-288 weeks). The cumulative probabilities of a VR at weeks 96, 144, and 192 from treatment initiation were 78.0%, 92.7%, and 95.1%, respectively. The VR rate was 97.2% (35/36) in HBeAg-positive patients and 100% (5/5) in HBeAg-negative patients. In multivariate analysis, HBeAg positivity (odds ratio [OR], 9.231; 95% confidence interval [CI], 1.03-82.91; P=0.047) and a high baseline HBV DNA level (OR, 0.170; 95% CI, 0.08-0.37; P=0.000) were independently associated with a delayed virologic response. No patient developed genotypic resistance to ETV during follow-up. CONCLUSIONS: Long-term ETV monotherapy is effective for achieving a VR in treatment-naive CHB patients exhibiting a PVR to ETV. HBeAg positivity and high baseline HBV DNA level were independently associated with a delayed virologic response.
Adult
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Aged
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Antiviral Agents/*therapeutic use
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DNA, Viral/blood
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Drug Administration Schedule
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Female
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Genotype
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Guanine/*analogs & derivatives/therapeutic use
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Hepatitis B e Antigens/blood
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Hepatitis B virus/genetics
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Hepatitis B, Chronic/*drug therapy/pathology/virology
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Humans
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Liver Cirrhosis/etiology/radiography/ultrasonography
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Magnetic Resonance Imaging
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Male
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Middle Aged
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Multivariate Analysis
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Odds Ratio
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Real-Time Polymerase Chain Reaction
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Retrospective Studies
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Tomography, X-Ray Computed
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Treatment Outcome