Journal
LIVER INTERNATIONAL
Volume 40, Issue 12, Pages 2961-2971Publisher
WILEY
DOI: 10.1111/liv.14606
Keywords
hepatitis B core antigen; hepatitis B RNA; hepatitis B surface antigen; relapse
Categories
Funding
- Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
- Thailand Research Fund (TRF) [RTA628004]
- Center of Excellence in Hepatitis and Liver Cancer, Chulalongkorn University
- Thai Association for the Study of the Liver
- The Gastroenterological Association of Thailand
Ask authors/readers for more resources
Background & Aims The safe discontinuation of nucleos(t)ide analogue therapy remains challenging in chronic hepatitis B. We investigated the potential role of quantitative hepatitis B surface antigen, hepatitis B core-related antigen and hepatitis B virus RNA at the end of treatment in predicting off-therapy relapse. Methods Patients who fulfilled the stopping criteria of the Asian Pacific Association for the Study of the Liver guideline were enrolled. Virological relapse was defined as hepatitis B virus DNA level greater than 2000 IU/mL, and clinical relapse was defined as virological relapse plus alanine aminotransferase level of more than twice the upper limit of normal. Results Ninety-two patients participated. The combination of end-of-treatment hepatitis B core-related antigen and hepatitis B virus RNA levels was most predictive of clinical relapse. Multivariate analysis revealed that end-of-treatment hepatitis B core-related antigen and hepatitis B virus RNA were independently associated with clinical relapse. During follow-up, no patients with undetectable hepatitis B core-related antigen (<3.0 log(10)U/mL) and hepatitis B virusRNA (<2.0 log(10)copies/mL) at end of treatment developed clinical relapse, in comparison with 22.9% and 62.5% patients with detectable levels of one or both biomarkers respectively. End-of-treatment quantitative hepatitis B surface antigen was linked to a likelihood of hepatitis B surface antigen clearance. Conclusions The combined hepatitis B core-related antigen and hepatitis B virus RNA assays at end of treatment were highly predictive of subsequent clinical relapse. These novel biomarkers could potentially be used to identify patients who could safely discontinue nucleos(t)ide analogue therapy.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available