Serum HBsAg Decline During Long-term Potent Nucleos(t)ide Analogue Therapy for Chronic Hepatitis B and Prediction of HBsAg Loss

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http://jid.oxfordjournals.org/content/204/3/415.abstract?etoc

Serum HBsAg Decline During Long-term Potent Nucleos(t)ide Analogue Therapy for

Chronic Hepatitis B and Prediction of HBsAg Loss

Roeland Zoutendijk1,

Bettina E. Hansen1,2,

Anneke J. van Vuuren1,

A. B. Boucher3 and

Harry L. A. Janssen1

+ Author Affiliations

1Department of Gastroenterology and Hepatology

2Department of Biostatistics

3Department of Virology, Erasmus MC University Medical Center, Rotterdam, the

Netherlands

Correspondence: H. L. A. Janssen, MD, PhD, Department of Gastroenterology and

Hepatology, Erasmus MC, University Medical Center Rotterdam, Gravendijkwal 230,

Room Ha 204, 3015 CE Rotterdam, the Netherlands (h.janssen@...).

Abstract

Nucleos(t)ide analogues strongly inhibit viral replication in chronic hepatitis

B (CHB) infection, but knowledge of their long-term effect on serum hepatitis B

surface antigen (HBsAg) levels and HBsAg loss is lacking. Seventy-five CHB

patients with virological response (VR) to ETV or TDF were included. HBsAg

decline 2 years after VR was most pronounced in HBeAg-positive patients. Age,

alanine aminotransferase, and HBeAg loss were associated with HBsAg decline in

HBeAg-positive patients. Predicted median time to HBsAg loss was 36 years for

HBeAg-positive and 39 years for HBeAg-negative patients. Thus, most patients

treated with ETV and TDF will probably need decades of therapy to achieve HBsAg

loss.

Received January 28, 2011.

Accepted March 22, 2011.