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Study on post-treatment relapse in HBeAg positive CHB patients

Lu, J and Li, J and Liu, Y and Ren, S and Cao, Z and Jin, Y and Ma, L and Shen, C and Chen, X (2015) Study on post-treatment relapse in HBeAg positive CHB patients. PLoS ONE, 10 (11).

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Abstract

© 2015 Lu et al.This is an open access article distributed under the terms of the Creative Commons Attribution License ,which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background Many factors are associated with post-treatment relapse in CHB patients, and there are no effective factors to predict relapse. In this study, we investigate the influence factors associated with post-treatment relapse and their predictive value in HBeAg positive CHB (ePCHB). Methods The factors associated with post-treatment relapse were analyzed firstly by a retrospective study in eP-CHB. Variables included age, sex, regimen, baseline HBeAg and HBV DNA level, total course of treatment as well as duration of consolidation therapy after HBeAg seroconversion. The predictive effects of the influence factors were evaluated in an eP-CHB prospective cohort. Results 89 patients were enrolled in the retrospective study, 42(47.2%) relapsed after discontinuation of treatment. Factors related to post-treatment relapse were total course of treatment, duration of consolidation therapy and baseline HBV DNA level. Relapse rates in patients with total course >36 months, consolidation duration >12 months and baseline HBV DNA level < 1.0E+5IU/ml were lower than those of total course <24 months (P = 0.002), consolidation duration ≤1 = 0.01) respectively. Patients with HBV DNA ≥ 1.0E+7IU/ml plus HBeAg<200COI at baseline had the highest relapse rate and cumulative relapse rate than the other three arms (P = 0.048 and 0.008 respectively). Logistic regression analysis demonstrated that baseline HBV DNA level, duration of consolidation therapy and combination of baseline HBV DNA and HBeAg (IgDNA/IgHBeAg) were independent factors to predict posttreatment relapse. The model based on baseline IgDNA/IgHBeAg and consolidation duration worked well in predicting post-treatment relapse in the prospective study and the accuracy, specificity, sensitivity, PPV and NPV for prediction were 80.3%, 81.1%, 79.2%, 73.1%and 85.7% respectively. Conclusions Virological factors including baseline HBV DNA, HBeAg and treatment course were major influence factors associated with post-treatment relapse in eP-CHB. Patients with higher HBV DNA and lower HBeAg levels at baseline, shorter total course as well as consolidation therapy were more likely to develop relapse after discontinuation of therapy. The antiviral therapy in eP-CHB patients should be individually managed at different levels. It is better to treat those with higher viral load and lower HBeAg levels at baseline for a longer course, especially longer consolidation duration so as to decrease the relapse rate.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Lu, J
Li, J
Liu, Y
Ren, S
Cao, Z
Jin, Y
Ma, L
Shen, Cchs97@pitt.eduCHS97
Chen, X
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
EditorSchlaak, Joerg F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Date: 2 November 2015
Date Type: Publication
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Journal or Publication Title: PLoS ONE
Volume: 10
Number: 11
DOI or Unique Handle: 10.1371/journal.pone.0141072
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Infectious Diseases and Microbiology
Refereed: Yes
Date Deposited: 23 Aug 2016 14:44
Last Modified: 02 Feb 2019 16:56
URI: http://d-scholarship.pitt.edu/id/eprint/28368

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