Young chronic hepatitis b patients with nucleos(t)ide analogue-induced hepatitis b e antigen seroconversion have a higher risk of HBV reactivation
Journal
Journal of Infectious Diseases
Journal Volume
206
Journal Issue
10
Pages
1521-1531
Date Issued
2012
Author(s)
Abstract
Background. It is unclear whether hepatitis B e antigen (HBeAg) seroconversion induced by nucleos(t)ide analogues (NUC) has a prognosis that is similar to that of spontaneous HBeAg seroconversion.Methods.A total of 148 noncirrhotic NUC-induced HBeAg seroconverters were consecutively enrolled. A historical control of 407 noncirrhotic spontaneous HBeAg seroconverters was also recruited. We compared the rates of HBeAg seroreversion and HBV reactivation between these 2 cohorts.Results.There were 1652.8 and 465.2 person-years of follow-up for spontaneous and NUC-induced HBeAg seroconverters, respectively. Compared with NUC-induced seroconverters, spontaneous seroconverters were younger when achieving HBeAg seroconversion. We thus compared these 2 cohorts according to their age at HBeAg seroconversion. In patients achieving HBeAg seroconversion before 30 years of age, NUC-induced seroconverters had a higher 2-year HBeAg seroreversion rate than spontaneous seroconverters (12.0 vs 2.9; P =. 004) and were at a higher risk of HBV reactivation (hazard ratio, 4.6; 95 confidence interval, 1.5-14.4). Using multivariate analysis, NUC-induced HBeAg seroconversion remained a risk factor of both endpoints in young HBeAg seroconverters.Conclusion.NUC-induced HBeAg seroconverters may not have durable response after stopping therapy. For patients achieving HBeAg seroconversion before 30 years of age, the risk of HBeAg seroreversion and HBV reactivation is higher in NUC-induced seroconverters than spontaneous HBeAg seroconverters. ? 2012 The Author.
SDGs
Other Subjects
adefovir; alanine aminotransferase; entecavir; hepatitis B(e) antigen; lamivudine; nucleoside analog; tenofovir; adult; age distribution; alanine aminotransferase blood level; article; cohort analysis; controlled study; drug efficacy; drug safety; female; genotype; hepatitis B; Hepatitis B virus; human; incidence; major clinical study; male; priority journal; real time polymerase chain reaction; seroconversion; treatment duration; treatment response; virus reactivation
Publisher
Oxford University Press
Type
journal article