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Probability of HBsAg loss after nucleo(s)tide analogue withdrawal depends on HBV genotype and viral antigen levels
DC Field | Value | Language |
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dc.contributor.author | 박준용 | - |
dc.contributor.author | 안상훈 | - |
dc.date.accessioned | 2022-07-08T03:00:26Z | - |
dc.date.available | 2022-07-08T03:00:26Z | - |
dc.date.issued | 2022-05 | - |
dc.identifier.issn | 0168-8278 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/188617 | - |
dc.description.abstract | Background & aims: Nucleo(s)tide analogue (NUC) withdrawal may result in HBsAg clearance in a subset of patients. However, predictors of HBsAg loss after NUC withdrawal remain ill-defined. Methods: We studied predictors of HBsAg loss in a global cohort of HBeAg-negative patients with undetectable HBV DNA who discontinued long-term NUC therapy. Patients requiring retreatment after treatment cessation were considered non-responders. Results: We enrolled 1,216 patients (991 with genotype data); 98 (8.1%) achieved HBsAg loss. The probability of HBsAg loss was higher in non-Asian patients (adjusted hazard ratio [aHR] 8.26, p <0.001), and in patients with lower HBsAg (aHR 0.243, p <0.001) and HBV core-related antigen (HBcrAg) (aHR 0.718, p = 0.001) levels. Combining HBsAg (<10, 10-100 or >100 IU/ml) and HBcrAg (<2log vs. ≥2 log) levels improved prediction of HBsAg loss, with extremely low rates observed in patients with HBsAg >100 IU/ml with detectable HBcrAg. HBsAg loss rates also varied with HBV genotype; the highest rates were observed for genotypes A and D, and none of the patients with HBV genotype E experienced HBsAg loss (p <0.001 for the overall comparison across genotypes; p <0.001 for genotypes A/D vs. genotypes B/C). HBV genotype C was independently associated with a higher probability of HBsAg loss when compared to genotype B among Asian patients (aHR 2.494; 95% CI 1.490-4.174, p = 0.001). Conclusions: The probability of HBsAg loss after NUC cessation varies according to patient ethnicity, HBV genotype and end-of-treatment viral antigen levels. Patients with low HBsAg (<100 IU/ml) and/or undetectable HBcrAg levels, particularly if non-Asian or infected with HBV genotype C, appear to be the best candidates for treatment withdrawal. Lay summary: A subset of patients may achieve clearance of hepatitis B surface antigen (HBsAg) - so-called functional cure - after withdrawal of nucleo(s)tide analogue therapy. In this multicentre study of 1,216 patients who discontinued antiviral therapy, we identified non-Asian ethnicity, HBV genotype C, and low hepatitis B surface antigen and hepatitis B core-related antigen levels as factors associated with an increased chance of HBsAg loss. | - |
dc.description.statementOfResponsibility | open | - |
dc.language | English | - |
dc.publisher | Elsevier | - |
dc.relation.isPartOf | JOURNAL OF HEPATOLOGY | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.subject.MESH | Antiviral Agents / therapeutic use | - |
dc.subject.MESH | DNA, Viral | - |
dc.subject.MESH | Genotype | - |
dc.subject.MESH | Hepatitis B Core Antigens | - |
dc.subject.MESH | Hepatitis B Surface Antigens* | - |
dc.subject.MESH | Hepatitis B e Antigens | - |
dc.subject.MESH | Hepatitis B virus / genetics | - |
dc.subject.MESH | Hepatitis B, Chronic* / drug therapy | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Probability | - |
dc.title | Probability of HBsAg loss after nucleo(s)tide analogue withdrawal depends on HBV genotype and viral antigen levels | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Internal Medicine (내과학교실) | - |
dc.contributor.googleauthor | Milan J Sonneveld | - |
dc.contributor.googleauthor | Shao-Ming Chiu | - |
dc.contributor.googleauthor | Jun Yong Park | - |
dc.contributor.googleauthor | Sylvia M Brakenhoff | - |
dc.contributor.googleauthor | Apichat Kaewdech | - |
dc.contributor.googleauthor | Wai-Kay Seto | - |
dc.contributor.googleauthor | Yasuhito Tanaka | - |
dc.contributor.googleauthor | Ivana Carey | - |
dc.contributor.googleauthor | Margarita Papatheodoridi | - |
dc.contributor.googleauthor | Florian van Bömmel | - |
dc.contributor.googleauthor | Thomas Berg | - |
dc.contributor.googleauthor | Fabien Zoulim | - |
dc.contributor.googleauthor | Sang Hoon Ahn | - |
dc.contributor.googleauthor | George N Dalekos | - |
dc.contributor.googleauthor | Nicole S Erler | - |
dc.contributor.googleauthor | Christoph Höner Zu Siederdissen | - |
dc.contributor.googleauthor | Heiner Wedemeyer | - |
dc.contributor.googleauthor | Markus Cornberg | - |
dc.contributor.googleauthor | Man-Fung Yuen | - |
dc.contributor.googleauthor | Kosh Agarwal | - |
dc.contributor.googleauthor | Andre Boonstra | - |
dc.contributor.googleauthor | Maria Buti | - |
dc.contributor.googleauthor | Teerha Piratvisuth | - |
dc.contributor.googleauthor | George Papatheodoridis | - |
dc.contributor.googleauthor | Chien-Hung Chen | - |
dc.contributor.googleauthor | Benjamin Maasoumy | - |
dc.contributor.googleauthor | CREATE study group | - |
dc.identifier.doi | 10.1016/j.jhep.2022.01.007 | - |
dc.contributor.localId | A01675 | - |
dc.contributor.localId | A02226 | - |
dc.relation.journalcode | J01441 | - |
dc.identifier.eissn | 1600-0641 | - |
dc.identifier.pmid | 35092743 | - |
dc.subject.keyword | HBV genotype | - |
dc.subject.keyword | HBcrAg | - |
dc.subject.keyword | HBsAg | - |
dc.subject.keyword | HBsAg loss | - |
dc.contributor.alternativeName | Park, Jun Yong | - |
dc.contributor.affiliatedAuthor | 박준용 | - |
dc.contributor.affiliatedAuthor | 안상훈 | - |
dc.citation.volume | 76 | - |
dc.citation.number | 5 | - |
dc.citation.startPage | 1042 | - |
dc.citation.endPage | 1050 | - |
dc.identifier.bibliographicCitation | JOURNAL OF HEPATOLOGY, Vol.76(5) : 1042-1050, 2022-05 | - |
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