Serum hepatitis B surface antigen monitoring in long-term lamivudine-treated hepatitis B virus patients

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http://www.ingentaconnect.com/content/bsc/jvh/2011/00000018/00000010/art00009

Serum hepatitis B surface antigen monitoring in long-term lamivudine-treated

hepatitis B virus patients

Authors: Gramenzi, A.1; Loggi, E.1; Micco, L.1; Cursaro, C.1; Fiorino, S.1;

Galli, S.2; Gitto, S.1; Galli, C.3; Furlini, G.2; Bernardi, M.1; Andreone, P.1

Source: Journal of Viral Hepatitis, Volume 18, Number 10, 1 October 2011 , pp.

e468-e474(7)

Publisher: Wiley-Blackwell

Abstract:

Summary.  Serum hepatitis B virus surface antigen (HBsAg) levels have been

suggested to predict interferon response in chronic hepatitis B. A few data are

available on the role of HBsAg measurement in nucleos(t)ide analogues (NA)

treatment. We retrospectively investigated the relation between HBsAg changes

and main treatment outcomes during long-term lamivudine treatment in hepatitis e

antigen (HBeAg)-negative chronic hepatitis B. A total of 42 HBeAg-negative

patients were consecutively enrolled in an open-label study on long-term

lamivudine monotherapy (150 mg/die). Serum HBsAg levels were quantified every

6 months by Architect assay (Abbott Diagnostics). HBV-DNA was quantified

quarterly by real-time PCR (Roche Diagnostics). The median duration of

lamivudine treatment was 66 months (20-153). One patient (2%) was a primary

nonresponder, 35 (83%) developed virological breakthrough (VB) and the remaining

six patients (14%) were classified as long-term on-treatment responders. During

treatment, HBsAg levels decreased only in long-term on-treatment responders,

while no changes were observed in resistant patients. Failure to achieve a

decrease of 0.7 log10 IU/mL in serum HBsAg at month six of lamivudine had a

positive predictive value of developing VB of 90% and a negative predictive

value of 100%. These high predictive values were also maintained in the subgroup

of patients negative for HBV-DNA at month six.

The results of this study with a small sample size suggest a role of

on-treatment HBsAg quantification in the management of lamivudine-treated

patients. If validated prospectively in a larger patient cohort, HBsAg

measurements would be a useful adjunct to optimize antiviral therapy.

Document Type: Research article

DOI: 10.1111/j.1365-2893.2011.01473.x

Affiliations:1: Department of Clinical Medicine, University of Bologna, Bologna,

Italy 2: Microbiology Section, Department of Clinical and Experimental Medicine,

University of Bologna, Bologna, Italy 3: Scientific Affairs, Abbott Diagnostics,

Rome, Italy

Publication date: 2011-10-01

[Guest guest]

http://www.ingentaconnect.com/content/bsc/jvh/2011/00000018/00000010/art00009

Serum hepatitis B surface antigen monitoring in long-term lamivudine-treated

hepatitis B virus patients

Authors: Gramenzi, A.1; Loggi, E.1; Micco, L.1; Cursaro, C.1; Fiorino, S.1;

Galli, S.2; Gitto, S.1; Galli, C.3; Furlini, G.2; Bernardi, M.1; Andreone, P.1

Source: Journal of Viral Hepatitis, Volume 18, Number 10, 1 October 2011 , pp.

e468-e474(7)

Publisher: Wiley-Blackwell

Abstract:

Summary.  Serum hepatitis B virus surface antigen (HBsAg) levels have been

suggested to predict interferon response in chronic hepatitis B. A few data are

available on the role of HBsAg measurement in nucleos(t)ide analogues (NA)

treatment. We retrospectively investigated the relation between HBsAg changes

and main treatment outcomes during long-term lamivudine treatment in hepatitis e

antigen (HBeAg)-negative chronic hepatitis B. A total of 42 HBeAg-negative

patients were consecutively enrolled in an open-label study on long-term

lamivudine monotherapy (150 mg/die). Serum HBsAg levels were quantified every

6 months by Architect assay (Abbott Diagnostics). HBV-DNA was quantified

quarterly by real-time PCR (Roche Diagnostics). The median duration of

lamivudine treatment was 66 months (20-153). One patient (2%) was a primary

nonresponder, 35 (83%) developed virological breakthrough (VB) and the remaining

six patients (14%) were classified as long-term on-treatment responders. During

treatment, HBsAg levels decreased only in long-term on-treatment responders,

while no changes were observed in resistant patients. Failure to achieve a

decrease of 0.7 log10 IU/mL in serum HBsAg at month six of lamivudine had a

positive predictive value of developing VB of 90% and a negative predictive

value of 100%. These high predictive values were also maintained in the subgroup

of patients negative for HBV-DNA at month six.

The results of this study with a small sample size suggest a role of

on-treatment HBsAg quantification in the management of lamivudine-treated

patients. If validated prospectively in a larger patient cohort, HBsAg

measurements would be a useful adjunct to optimize antiviral therapy.

Document Type: Research article

DOI: 10.1111/j.1365-2893.2011.01473.x

Affiliations:1: Department of Clinical Medicine, University of Bologna, Bologna,

Italy 2: Microbiology Section, Department of Clinical and Experimental Medicine,

University of Bologna, Bologna, Italy 3: Scientific Affairs, Abbott Diagnostics,

Rome, Italy

Publication date: 2011-10-01