Background/Aims We investigated the dynamics of serum HBV pre-genomic RNA (pgRNA) and hepatitis B core-related antigen (HBcrAg) in patients receiving nucleos(t)ide analogues (NAs) and their predictability for favourable suppression of serum hepatitis B surface antigen (HBsAg).
Methods Serum viral biomarkers were measured at baseline, weeks 4, 12, 24, 36, and 48 of treatment. Patients were followed up thereafter and serum HBsAg level was measured at end of follow-up (EOFU). Favourable HBsAg response (FHR) was defined as ≤100 IU/mL or HBsAg seroclearance upon EOFU.
Results Twenty-eight hepatitis B e antigen (HBeAg)-positive and 36 HBeAg-negative patients (median, 38.2 years old; 71.9% male) were recruited with median follow-up duration of 17.1 years (interquartile range, 12.8–18.2). For the entire cohort, 22/64 (34.4%) achieved FHR. For HBeAg-positive patients, serum HBV pgRNA decline at week 4 was significantly greater for patients with FHR compared to non-FHR (5.49 vs. 4.32 log copies/mL, respectively; P=0.016). The area under the receiver-operating-characteristic curve (AUROC) for week 4 HBV pgRNA reduction to predict FHR in HBeAg-positive patients was 0.825 (95% confidence interval [CI], 0.661–0.989). For HBeAg-negative patients, instead of increase in serum HBcrAg in non-FHR patients, FHR patients had median reduction in HBcrAg at week 4 (increment of 1.75 vs. reduction of 2.98 log U/mL; P=0.023). The AUROC for week 4 change of HBcrAg to predict FHR in HBeAg-negative patients was 0.789 (95% CI, 0.596–0.982).
Conclusions Early on-treatment changes of serum HBV pgRNA and HBcrAg at 4 weeks predict HBsAg seroclearance or ≤100 IU/mL in NA-treated CHB patients upon long-term FU.
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Methods A retrospective observational study was conducted in patients with chronic HBV infection and classified as inactive carriers or immune-tolerant. Epidemiological variables of age, sex, immigrant, alcohol consumption, and body mass index (BMI), as well as virological variables (HBV DNA) and transaminase level were collected throughout the follow-up. The LF grade was evaluated by transient elastography. The cutoff value for significant fibrosis (SF) was liver stiffness ≥7.9 kPa.
Results A total of 214 patients were included in the analysis, and 62% of them had a BMI ≥25 kg/m2 . During follow-up, 4% of patients showed transaminase elevation (<1.5 times normal). Most patients had a viral DNA level <2,000 IU/mL (83%). Data on LF were available in 160 patients; of these, 14% had SF, 9% F3, and 6% F4. The variables associated with the presence of SF were transaminase alteration during follow-up, as 23% of patients with SF had elevated transaminases versus 3% of patients without SF (P<0.005), and BMI, as the vast majority of patients with SF (88%) had a BMI ≥25 kg/m2 versus 56% of patients without SF (P<0.05).
Conclusions In patients with chronic HBV infection and normal transaminases, liver damage does not seem to be related to DNA levels, alcohol consumption, or immigrant status. SF seems to be associated with transaminase alteration during follow-up and elevated BMI. It is therefore recommended to measure LF grade with validated non-invasive methods in such patients.
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Background/Aims The aim of this study was to establish the characteristics of children with hepatitis B
e antigens (HBeAg) positive chronic hepatitis B who were cleared of hepatitis B surface antigens (HBsAg) as
a result of lamivudine treatment. Methods: Seventy-six children with chronic hepatitis B who were
seropositive for HBeAg were treated with lamivudine for at least 6 months. HBeAg seroconversion occurred
during treatment in 49 of these children, who were then followed up to assess their clearance of serum HBsAg.
Various clinical variables were compared between those patients who were cleared of HBsAg and those who
were not, including age, pretreatment serum levels of alanine aminotransferase (ALT) and hepatitis B virus
(HBV) DNA, treatment duration, the time elapsed between initiation of treatment and ALT normalization, HBV
DNA negativization, HBeAg seroconversion, and HBsAg clearance. Results: HBsAg disappeared in 13 of the
49 (26.5%) patients who experienced lamivudine-induced HBeAg seroconversion; HBsAg did not reappear
during follow-up period (1-86 months). The time that elapsed between initiation of lamivudine treatment and
total HBsAg clearance was 25.9±27.1 months (mean±SD; range: 5-104 months). The age at which treatment
was initiated was the only factor associated with HBsAg clearance. Children who were cleared of HBsAg were
significantly younger than those who were not (5.1±4.3 years vs. 7.9±4.9 years, respectively; P=0.006). All
13 of these patients eventually produced antibodies to HBsAg. Conclusions: Younger children (age <7 years
old) have a higher chance of HBsAg clearance than older children after the treatment of HBeAg-positive
chronic hepatitis B with lamivudine. (Korean J Hepatol 2009;15:168-178)
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Predictive value of HBeAg titer dynamics for HBsAg clearance in pediatric chronic hepatitis B Sukjin Hong, Jun Hyun Hwang, Keumoung Kim, Younghae Do, Naeun Kwak, Hyo Rim Suh, Sujin Choi, Ben Kang, Byung-Ho Choe Frontiers in Pediatrics.2025;[Epub] CrossRef
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Current Role of Lamivudine Regarding Therapeutic Response and Resistance in Children with Chronic Hepatitis B Suk Jin Hong, Yeo Hyang Kim, Byung-Ho Choe, Hyo Jung Park, Won-Young Tak, Young-Oh Kweon Pediatric Gastroenterology, Hepatology & Nutrition.2013; 16(2): 80. CrossRef
Chang Mo Moon, M.D., Do Young Kim, M.D., Ki Jun Song, Ph.D.1, Ja Kyung Kim, M.D.,
Hyun Woong Lee, M.D., Jung Min Lee, M.D., Ki Tae Yoon, M.D., Yong Han Paik, M.D.,
Dong Ki Kim, Ph.D.1, Kwang-Hyub Han, M.D., Chae Yoon Chon, M.D., Young Myoung Moon, M.D.,
and Sang Hoon Ahn, M.D.
Background/Aims The long-term virologic and biochemical changes in patients with HBeAg negative HBV infection, especially in Asia, remain unclear. To address this issue, we conducted a 3 year- retrospective, cohort study. Methods: A total of 157 patients with HBeAg negative HBV infection who were monitored without treatment were reviewed between January 1999 and March 2004. Those patients were followed up every 3 months with liver function tests and serologic tests. All patients were stratified into 3 groups; inactive carrier (IC), viremic carrier (VC) and chronic hepatitis (CH). Serum HBV DNA was measured by a hybridization assay (sensitivity: 1.4×105 genomes/mL, Digene Diagnostics, Silver Spring, USA). Results: The median age of enrolled patients was 42.7 years (M:F=2.3:1). By single time-point observations, the 3 year-cohort prevalence of HBeAg negative CH varied from 12.7 to 35.8% (median 20.7%) HBeAg negative CH was accumulated over time (P=0.002) and transition rates among three groups after 3 years of follow-up are as follows: IC to CH, 6.0%; IC to VC, 4.1%; VC to CH, 23.2%. VC seems to be a disease state in the middle of transition from IC to CH. Conclusions: We demonstrated the dynamic changing patterns of HBeAg negative CH with time, of which the change from IC or VC to CH was dominant. (Korean J Hepatol 2006;12:163-172)
Background/Aims The aim of this study was to compare the efficacy of lamivudine therapy between
chronic hepatitis B (CHB) patients, whose ALT levels less than 2 times the upper limit of normal (ULN) and
patients whose ALT levels are more than 2 times ULN. Methods: We retrospectively analyzed 508 consecutive
patients with HBeAg-positive CHB who were treated with lamivudine for 1 year or more. Forty-six patients
(Group A) with pretreatment ALT levels less than 2 times ULN were retrospectively compared with 462
patients (Group B) whose ALT levels are more than 2 times ULN. Results: HBeAg seroconversion was
achieved in 15 (32.6%) of group A and 162 (35.1%) of group B. The cumulative rates of HBeAg seroconversion
in group A and B were 19% and 21% at 12 months; 35% and 31% at 24 months; and 38% and 39% at 36
months, respectively. HBV breakthrough was observed in 20 (43.5%) of group A and 192 (41.6%) of group B.
The cumulative breakthrough rates of group A and B were 18% and 12% at 12 months; 33% and 29 % at 18
months; 45% and 42% at 24 months, respectively. Post-treatment relapse in group A and B occurred in 56%
(5/9) and 41% (44/108), respectively. Therefore, the rates of the HBeAg seroconversion, breakthrough, and
post-treatment relapse were not significantly different between these two groups. Conclusions: Lamivudine
therapy in HBeAg-positive CHB patients whose ALT levels are minimally elevated is as effective as in
treatment of the patients whose pretreated ALT levels are twice more than ULN. (Korean J Hepatol
2007;13:146-156)
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