Earlier and Higher Rate of Hepatitis B Virus Relapse After Discontinuing Tenofovir Versus Entecavir in Hepatitis B e Antigen–Positive Patients. (11th December 2021)

• Record Type: Journal Article
• Authors: Chen, Chien-Hung; Peng, Cheng-Yuan; Kuo, Yuan-Hung; Hu, Tsung-Hui; Hung, Chao-Hung; Wang, Jing-Houng; Lu, Sheng-Nan
• Is Part Of: Journal of infectious diseases. Volume 225:Number 11(2022)
• Page Start: 1974
• Page End: 1981
• Publication Date: 2021-12-11
• Subjects: chronic hepatitis B -- hepatitis B surface antigen -- hepatitis B core-related antigen -- entecavir -- tenofovir; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiab596
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract: Background: This study investigated the incidence and predictors of hepatitis B virus (HBV) relapse in patients with hepatitis B e antigen (HBeAg)–positive chronic hepatitis B who discontinued entecavir (ETV) or tenofovir disoproxil fumarate (TDF). Methods: A total of 205 and 111 HBeAg-positive patients without cirrhosis who had stopped ETV or TDF treatment, respectively, for at least 6 months were recruited. Results: In the entire cohort, patients with HBeAg seroconversion during treatment, and propensity score–matched patients, those who discontinued TDF had significantly higher rates of virological and clinical relapse than patients who discontinued ETV therapy. Multivariate analysis identified that TDF was independently associated with virological and clinical relapse in the entire cohort and subgroup analysis. Patients with HBeAg loss without anti-HBe antibody formation during treatment had significantly higher rates of off-therapy HBV relapse and HBeAg seroreversion than patients with HBeAg seroconversion during treatment. The hepatitis B core-related antigen (HBcrAg) level at end of treatment (EOT) was independently associated with HBV relapse and HBeAg seroreversion in all patients and patients with HBeAg seroconversion during treatment. Conclusions: TDF therapy, HBeAg loss without seroconversion during treatment, and higher HBcrAg levels at EOT are significant predictors of HBV relapse in HBeAg-positive patients who discontinued ETV or TDF. Abstract : Hepatitis B e antigen (HBeAg)–positive patients who discontinued tenofovir disoproxil fumarate (TDF) had significantly higher rates of hepatitis B virus relapse than those who discontinued entecavir. Higher end-of-treatment hepatitis B core-related antigen was an independent predictor of HBV relapse.