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<http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1746.2011.06766.x/abstract>
Intrahepatic response markers in chronic hepatitis B patients treated with
peginterferon alfa-2a and adefovir
R.B. Takkenberg1,*, V. Terpstra4, H.L. Zaaijer3, C.J. Weegink1, M.G.W.
Dijkgraaf4, P.L.M. Jansen1, M.G.H.M. Beld5, H.W. Reesink1DOI:
10.1111/j.1440-1746.2011.06766.x
© 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell
Publishing Asia Pty Ltd Issue
Journal of Gastroenterology and Hepatology
Accepted Article (Accepted, unedited articles published online for future
issues)
This is an Accepted Article that has been peer-reviewed and approved for
publication in the Journal of Gastroenterology and Hepatology, but has yet
to undergo copy-editing and proof correction. Please cite this article as
an “Accepted Article”; doi: 10.1111/j.1440-1746.2011.06766.x
Publication History Accepted manuscript online: 9 MAY 2011 06:56PM EST
Received date: 16-Dec-2010 , Accepted date: 27-Apr-2011
Abstract
Background: We investigated whether intrahepatic markers could predict
response in chronic hepatitis B patients treated with peg-IFN and adefovir
for 48 weeks.
Methods: Intrahepatic cccDNA, total intrahepatic HBV DNA and the proportion
of HBsAg and HBcAg positive hepatocytes in 16 HBeAg positive and 24 HBeAg
negative patients were measured at baseline and at the end of treatment.
Results: Baseline intrahepatic markers were not associated with sustained
virological response (SVR) defined as HBV DNA <2,000 IU/mL and persistent
normal ALT levels at the end of follow-up (week 72). At the end of
treatment, intrahepatic cccDNA and total intrahepatic HBV DNA in HBeAg
positive patients were significantly lower in patients with HBeAg
seroconversion (p = 0.016 and p = 0.010) with positive predictive values
(PPV) for SVR of 80% and 80% respectively. In HBeAg negative patients,
intrahepatic cccDNA and total intrahepatic HBV DNA had declined
significantly at end of treatment (p = 0.035 and p = 0.041) and
corresponding PPV for SVR was 73% and 82%. In HBeAg positive patients,
median proportion of HBcAg positive hepatocytes declined significantly (p =
0.002) at end of treatment. In HBeAg negative patients, the proportion of
HBsAg positive hepatocytes had declined significantly at the end of
treatment (p = 0.0009). Using HBsAg ≤ 7.5% as limit, PPV for SVR in HBeAg
negative patients was 83%.
Conclusions: At end of treatment in HBeAg positive patients, intrahepatic
cccDNA and total intrahepatic HBV DNA were predictive for SVR. In HBeAg
negative patients a proportion of <7.5% HBsAg positive hepatocytes at end
of treatment was a strong predictor for SVR. |
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发表于 2011-5-10 22:57
