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Tytuł pozycji:

Study on the Retreatment, Outcome, and Potential Predictors of Recurrence in Patients With Recurrence of Hepatitis B After Functional Cure.

Tytuł:
Study on the Retreatment, Outcome, and Potential Predictors of Recurrence in Patients With Recurrence of Hepatitis B After Functional Cure.
Autorzy:
Lin X; First Department of Liver Disease Center, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Song A; First Department of Liver Disease Center, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Lu J; First Department of Liver Disease Center, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Zheng S; First Department of Liver Disease Center, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Hu Z; First Department of Liver Disease Center, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Ma L; First Department of Liver Disease Center, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Cao Z; Third Department of Liver Disease Center, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Li H; Third Department of Liver Disease Center, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Zheng Y; First Department of Liver Disease Center, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Ren S; First Department of Liver Disease Center, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Chen X; First Department of Liver Disease Center, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Źródło:
Frontiers in immunology [Front Immunol] 2022 Jul 04; Vol. 13, pp. 879835. Date of Electronic Publication: 2022 Jul 04 (Print Publication: 2022).
Typ publikacji:
Journal Article; Research Support, Non-U.S. Gov't
Język:
English
Imprint Name(s):
Original Publication: [Lausanne : Frontiers Research Foundation]
MeSH Terms:
Carcinoma, Hepatocellular*/drug therapy
Hepatitis B*/diagnosis
Hepatitis B*/drug therapy
Hepatitis B, Chronic*
Liver Neoplasms*/drug therapy
Antiviral Agents/therapeutic use ; Hepatitis B Antibodies ; Hepatitis B Surface Antigens ; Humans ; Interferon-alpha/therapeutic use ; Liver Cirrhosis/drug therapy ; Neoplasm Recurrence, Local/drug therapy ; Retreatment
References:
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Contributed Indexing:
Keywords: HBV; hepatitis B core antibody; hepatitis B surface antibody; high clearance rate; outcome; recurrence; retreatment
Substance Nomenclature:
0 (Antiviral Agents)
0 (Hepatitis B Antibodies)
0 (Hepatitis B Surface Antigens)
0 (Interferon-alpha)
Entry Date(s):
Date Created: 20220721 Date Completed: 20220722 Latest Revision: 20220724
Update Code:
20240105
PubMed Central ID:
PMC9289245
DOI:
10.3389/fimmu.2022.879835
PMID:
35860247
Czasopismo naukowe
Background: Studies about the retreatment and predictors for patients with hepatitis B recurrence after functional cure are rare. This study aimed to evaluate the effect of retreatment, outcome, and potential predictors of recurrence in patients with recurrence after functional cure.
Methods: A long-term follow-up was conducted with 32 cumulatively obtained patients who relapsed after cessation of pegylated interferon (Peg-IFN)-based antiviral treatment. The decision of whether to treatment or which therapeutic method to use [Peg-IFN or nucleos(t)ide analogs (NAs)] was based on the patient's preferences and wishes. The rate of achieving functional cure and the clinical outcomes of different therapeutic methods were analyzed. Hepatitis B surface antibody (anti-HBs) and hepatitis B core antibody (anti-HBc) levels were detected in patients with blood samples during follow-up to evaluate the predictive ability of recurrence.
Results: The follow-up time of 32 recurrence cases was 42-532 weeks after recurrence (median 226 weeks). In the 20 patients who received retreatment (15 received Peg-IFN and 5 received NAs only), the rate of functional cure was 65.0% (13/20); it was 86.7% (13/15) in the patients retreated with Peg-IFN. Three cases experienced recurrence again. Five patients received NA treatment, and no functional cure was achieved. No drug intervention was administered for 12 patients, 2 of them with hepatitis B virus (HBV) DNA spontaneous clearance, and one patient achieved spontaneous hepatitis B surface antigen (HBsAg) clearance during follow-up. Patients who relapsed after functional cure with Peg-IFN treatment did not have liver cirrhosis or hepatocellular carcinoma during the follow-up, regardless of whether they received retreatment. Anti-HBs and anti-HBc levels at the end of therapy were predictors of recurrence (p < 0.001, p = 0.023). The value of combining the above two indicators in predicting recurrence was further improved, the areas under the receiver operating characteristic curves were 0.833, at combining predictors >-0.386, the predictive sensitivity and specificity for recurrence were 86.67% and 90.62%.
Conclusion: The functional cure rate was above 80% for patients with recurrence treated by Peg-IFN. During the follow-up, liver cirrhosis and hepatocellular carcinoma were not observed in all recurrence cases. High levels of anti-HBs and anti-HBc at the time of drug discontinuation are less likely to relapse.
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2022 Lin, Song, Lu, Zheng, Hu, Ma, Cao, Li, Zheng, Ren and Chen.)

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