Clinical—Liver, Pancreas, and Biliary TractNucleos(t)ide Analogues Only Induce Temporary Hepatitis B e Antigen Seroconversion in Most Patients With Chronic Hepatitis B
Section snippets
Study Population
All adult patients with chronic HBV infection (HBsAg-positivity for at least 6 months), referred to the Erasmus Medical Center between 1996 and 2009, who were treated with nucleos(t)ide analogue therapy for at least 6 months, and who tested HBeAg positive, antibody against HBeAg (anti-HBe) negative at the start of treatment, were eligible. Major exclusion criteria were as follows: co-infection with hepatitis C virus, hepatitis D virus, or human immunodeficiency virus, and treatment with
Results
Baseline characteristics of all patients are shown in Table 1. A total of 132 patients with chronic HBV infection treated with nucleos(t)ide analogues in our hospital were included for analysis. Overall, 67 patients were treated with LAM monotherapy, 33 with adefovir (ADV), 22 with entecavir, 6 with tenofovir, 2 with ADV–LAM combination therapy, and 2 with tenofovir-LAM. A total of 117 (89%) patients were nucleos(t)ide analogue treatment-naive, whereas 15 (11%) subjects had been treated
Discussion
Our study explores the long-term durability of nucleos(t)ide analogue-induced HBeAg seroconversion. During a median follow-up period of 5 years after the development of nucleos(t)ide analogue-induced HBeAg seroconversion, only 31% of patients showed a durable remission, defined as HBeAg negativity and HBV-DNA levels less than 10,000 copies/mL. Moreover, sustained response was shown in just 2 of 9 patients who discontinued therapy after a consolidation therapy of at least 6 months. On-treatment
Acknowledgments
The authors thank the Department of Virology, Erasmus MC University Medical Center Rotterdam, for performing virologic testing, and Professor Wang, Department of Gastroenterology, Zong Shan Hospital, Fudan University, Shanghai, China, for her contribution to the manuscript.
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Conflicts of interest These authors disclose the following: Jurriën Reijnders has received speaker's honoraria from Novartis and Bristol-Myers Squibb; Harry Janssen has received research support and consulting fees from Bristol-Myers Squibb, Gilead, Novartis, and Roche, and research support from Schering-Plough. The remaining authors disclose no conflicts.
Funding Dr Janssen is a clinical fellow and Vidi laureate of The Netherlands Organisation for Scientific Research.