Hepatitis B e antigen seroconversion: A critical event in chronic hepatitis B virus Infection
Journal
Digestive Diseases and Sciences
Journal Volume
55
Journal Issue
10
Pages
2727-2734
Date Issued
2010
Author(s)
Abstract
Background Replication of hepatitis B virus (HBV) is the primary driver of disease progression and clinical outcomes in patients with chronic hepatitis B (CHB), but other factors, such as hepatitis B e antigen (HBeAg) status, also influence disease course. The importance of HBeAg seroconversion is underscored by current CHB treatment guidelines that recommend limiting the duration of antiviral therapy in HBeAg-positive patients who achieve seroconversion. Aims A 2-day meeting of leading hepatologists with extensive experience managing patients with CHB in the Asia-Pacific region was held with the overall goals of reviewing and evaluating (1) available data on the relationship between HBeAg seroconversion and clinical outcomes for patients with HBeAg-positive CHB, and (2) the ways in which seroconversion should influence patient management. Conclusions It was agreed that HBeAg seroconversion is an important serologic end point for patients with CHB and that achieving this goal should be an important consideration in treatment selection. Patients with HBeAg-positive CHB should consider pegylated interferon if they are aged <40 years (especially women), have lower HBV DNA levels, can afford this treatment, and have a lifestyle that would support adherence to injection therapy. Alternatively, ucleos(t)ide analogs are recommended in patients with alanine aminotransferase levels ?2 × the upper limit of normal, HBV DNA levels <9 log10 IU/ml, and compensated CHB. Entecavir, telbivudine, and tenofovir may be used as first-line therapy; they can be administered as a finite therapeutic course in HBeAg-positive patients who seroconvert. Telbivudine and tenofovir should be considered in women of child-bearing potential. ? Springer Science+Business Media, LLC 2010.
Subjects
Hepatitis B; Hepatitis B e antigen seroconversion; Oral nucleos(t)ide therapy; Pegylated interferon
SDGs
Other Subjects
adefovir; alanine aminotransferase; alpha fetoprotein; entecavir; hepatitis B surface antigen; hepatitis B(e) antigen; HLA B60 antigen; HLA DQB1 antigen; interferon; lamivudine; nucleoside derivative; peginterferon; telbivudine; tenofovir; virus DNA; antivirus agent; hepatitis B antibody; hepatitis B(e) antigen; add on therapy; alanine aminotransferase blood level; antiviral resistance; antiviral therapy; cancer risk; clinical trial; disease course; drug substitution; drug withdrawal; genotype; groups by age; haplotype; hepatitis B; Hepatitis B virus; hepatitis C; human; infection risk; lifestyle; liver cell carcinoma; nonhuman; patient care; patient compliance; pregnancy; priority journal; review; seroconversion; treatment outcome; treatment response; vertical transmission; virus reactivation; virus transmission; blood; growth, development and aging; hepatitis B; Hepatitis B virus; immunology; Antiviral Agents; Hepatitis B Antibodies; Hepatitis B e Antigens; Hepatitis B virus; Hepatitis B, Chronic; Humans
Type
review