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J Hepatol. 2013 Oct;59(4):709-16. doi: 10.1016/j.jhep.2013.06.007. Epub 2013 Jun 17.

Patterns of hepatitis B surface antigen decline and HBV DNA suppression in Asian treatment-experienced chronic hepatitis B patients after three years of tenofovir treatment.

Author information

1
Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong.

Abstract

BACKGROUND & AIMS:

Patterns of serum hepatitis B surface antigen (HBsAg) decline during nucleos(t)ide analogue (NA) therapy have not been well investigated.

METHODS:

We determined the cumulative serologic, virologic, and biochemical outcomes of 142 Asian CHB patients, with at least 6 months exposure to other NAs, receiving tenofovir with or without lamivudine for up to 3 years. Liver biochemistry, serum HBV DNA, and HBsAg levels were determined at baseline, 6 months and yearly from years 1 to 3.

RESULTS:

142, 123 (86.6%), and 70 (49.3%) CHB patients were followed up for 1, 2, and 3 years, respectively. Two phases of HBsAg decline were observed. Patients with baseline HBsAg ≥3 log IU/ml, when compared to patients with baseline HBsAg < 3 log IU/ml, had a greater median rate of HBsAg reduction through 3 years of treatment (0.155 and 0.039 log IU/ml/year respectively, p < 0.001). Among patients with 3 years of follow-up, there was a significantly greater median rate of HBsAg reduction during the first year when compared to the second and third years (0.220, 0.136, and 0.081 log IU/ml/year respectively, p < 0.001). HBeAg status, HBV genotype, and concomitant lamivudine therapy were not important determinants of HBsAg kinetics (all p > 0.05). The 3-year cumulative virologic suppression rate was 93.3%, with no cases of resistance detected.

CONCLUSIONS:

Serum HBsAg levels in NA-experienced patients receiving tenofovir demonstrated a variable pattern of decline, with slower rates of reduction noted in patients with lower baseline HBsAg levels, and could explain the rarity of HBsAg seroclearance during NA therapy.

KEYWORDS:

ALT; CHB; HBV; HBeAg; HBsAg; Nucleoside analogue; Nucleotide analogue; Surface antigen; TDF; Tenofovir; alanine aminotransferase; anti-HBs; antibody to the hepatitis B surface antigen; chronic hepatitis B; hepatitis B e antigen; hepatitis B surface antigen; hepatitis B virus; tenofovir disoproxil fumarate

PMID:
23792029
DOI:
10.1016/j.jhep.2013.06.007
[Indexed for MEDLINE]

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