标题: AASLD 2011:HBV Treatment Induced HBsAg Seroconversion to Anti-HBs in 9 Asian-Ame [打印本页] 作者: StephenW 时间: 2011-10-24 22:58 标题: AASLD 2011:HBV Treatment Induced HBsAg Seroconversion to Anti-HBs in 9 Asian-Ame
HBV Treatment Induced HBsAg Seroconversion to Anti-HBs in 9 Asian-American Patients: Experience in a Community Clinic
H. Lee1; K. Hu1; S. Tonthat1
1. GI/Hepatology, U.C. Irvine, Irvine, CA, United States.
Background: Although HBeAg seroconversion to anti-HBe has been a standard treatment endpoint for HBeAg+ patients, patients who achieve this endpoint have a 20-40% relapse rate over a 5 year period. HBsAg seroconversion appears to be a more durable endpoint of HBV treatment than HBeAg seroconversion, but it is difficult to achieve. Several natural history cohorts of HBV patients have shown a low incidence of spontaneous HBsAg seroconversion, approximately 0.5-1.0% per year. Registration trials of HBeAg+ patients on tenofovir DF have shown 10.8% of patients achieve HBsAg loss and 7.7% of patients seroconvert to anti-HBs over 4 years. However, HBsAg loss was not seen in Asian patients or in HBeAg-negative patients.
Aim: To assess the probability and durability of HBsAg seroconversion in Asian-American patients treated with standard of care (SOC) nucleos(t)ide analogue oral agents in a community clinic.
Methods: A retrospective chart review of patients with CHB, who received nucleos(t)ide therapy from a single Irvine, CA clinic from 2008-2010.
Results: We identified nine Asian-American patients on treatment with nucleos(t)ide analogs who achieved HBsAg seroconversion. 4/9 (44%) were male, 8/9 (89%) were HBeAg negative at baseline, and the median age was 48 y.o. 4/9 patients were started on therapy by their primary physician, and their baseline viral load and ALT were not available. For the five patients with complete data, the median starting HBV DNA level was 69,392 IU/ml, and median ALT level was 53 U/L. 6/9 patients were treated with tenofovir (one of whom had lamivudine + TDF), 2 were treated with entecavir (ETV), and 1 was treated with adefovir (ADV). All nine patients achieved a normal ALT and undetectable HBV DNA on treatment. Treatment was discontinued in one patient when he achieved a HBsAb level over 50 mIU/ml. He was treated for 27 months with entecavir before achieving this endpoint. Ten months later, this patient was found to have a viral load of 13,737 IU/ml (79,949 copies/ml). His HBsAg was detectable, and he was started on tenofovir (TDF) at the time of this abstract submission.
Conclusions: Our experience shows it is possible for HBeAg negative Asian-American patients to seroconvert to anti-HBs while on oral CHB therapy. Using a quantitative HBsAb level of >50 mIU/ml as an endpoint to discontinue therapy was difficult to achieve, and did not prevent relapse in the one patient who achieved it, despite a persistently detectable HBsAb level. Further studies are needed in larger patient populations to determine the best endpoint for stopping oral CHB therapy, to maximize durable seroconversion and viral suppression. 作者: StephenW 时间: 2011-10-24 23:00
乙肝治疗乙肝表面抗原诱导抗- HBs血清转换9亚裔美国人的患者:在一个社区诊所的经验
H.李1; K.胡锦涛1 S. Tonthat 1
1。 GI /肝脏,U.C.尔湾,加利福尼亚州欧文,美国。
HBV Treatment Induced HBsAg Seroconversion to Anti-HBs in 9 Asian-American Patients: Experience in a Community Clinic
Should the title be
HBV Treatment Induced HBsAg Seroconversion to Anti-HBs in 1 out of 9 Asian-American Patients: Experience in a Community Clinic
作者: StephenW 时间: 2011-10-25 12:06
MiddleAgeMan 发表于 2011-10-25 03:53
Hi. StephenW:
I found out that the title is misleading:
The title is not misleading. They did identify 9 patients who seroconverted to HbsAg negative.
All of them were on oral antiviral treatment.
I must admit this abstract cause me a lot of anxiety. They talked about one patient who stopped treatment when he achieved HBsAg -ve, AND HBsAb > 50 mIU/mL (10 mIU/mL is considered to be protective!). Yet this patient relapsed 10 months later, regaining HBsAg+ve and hbvdna. Would really like to find out more.
There is an embargo on all the papers, abstracts, and posters from AASLD 2011. Let's hope someone will give us more information after these are presented at the meeting. 作者: MiddleAgeMan 时间: 2011-10-25 12:17
Hi. StephenW:
You are right about the title. I was not reading carefully. However it is strange to me that the abstract does not mention the whole patient population.
You are not wrong. Yes, it did not say anything about the other 8: e.g. are they still on treatment?
I guess these questions can be asked when the abstract/poster is presented at the meeting. I get the feeling Conference organizers are limiting the words in abstracts/posters because there are so many. 作者: 2012痊愈 时间: 2011-10-25 12:38