Frequency and clinical outcomes of flares related to nucleos(t)ide analogue therapy in patients with chronic hepatitis B.

[Guest guest]

J Viral Hepat. 2011 Jul;18(7):e252-7. doi: 10.1111/j.1365-2893.2011.01448.x.

Epub 2011 Mar 1.Frequency and clinical outcomes of flares related to

nucleos(t)ide analogue therapy in patients with chronic hepatitis B.Zhang NP,

Reijnders JG, Perquin M, Hansen BE, Janssen HL.SourceDepartment of

Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam,

Rotterdam, The Netherlands Department of Gastroenterology and Hepatology,

Zhongshan Hospital, Fudan University, Shanghai, China Department of Epidemiology

and Biostatistics, Erasmus MC University Medical Center Rotterdam, Rotterdam,

The Netherlands.AbstractSummary.  Flares in chronic hepatitis B are often

detrimental but sometimes lead to sustained immune control and disease

remission. The aim of this study was to estimate the frequency of hepatitis

flares which occur during and/or after cessation of nucleos(t)ide analogue (NA)

therapy, and to assess their outcomes. In a single centre cohort study we

investigated 227 patients who received a total of 351 NA treatment courses. NA

therapy was discontinued after 149 treatment courses. In total, 27 flares were

observed during 9779 on-treatment patient-months. The frequency was estimated as

3.2 per 100 person-years (95% CI 2.2-4.7). Lamivudine (LAM)-treated patients

demonstrated the highest frequency (4.9/100 person-years, 95% CI 3.2-7.4).

Twenty (74%) of 27 on-therapy flares were associated with development of

genotypic resistance, which all occurred during LAM therapy. NA withdrawal

flares occurred after a median post-treatment follow-up of 3.5 months in 17

(11%) of 149 treatment discontinuations. No flares were observed in patients who

switched to another antiviral agent (n = 51). None of the on-therapy and

withdrawal flares related to NA therapy were associated with sustained disease

remission, and seven flares resulted in decompensated liver disease. In this

study, flares related to NA therapy never led to immune control and sustained

disease remission, and sometimes resulted in decompensated liver disease.© 2011

Blackwell Publishing Ltd.PMID: 21692940 [PubMed - in process]

[Guest guest]

J Viral Hepat. 2011 Jul;18(7):e252-7. doi: 10.1111/j.1365-2893.2011.01448.x.

Epub 2011 Mar 1.Frequency and clinical outcomes of flares related to

nucleos(t)ide analogue therapy in patients with chronic hepatitis B.Zhang NP,

Reijnders JG, Perquin M, Hansen BE, Janssen HL.SourceDepartment of

Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam,

Rotterdam, The Netherlands Department of Gastroenterology and Hepatology,

Zhongshan Hospital, Fudan University, Shanghai, China Department of Epidemiology

and Biostatistics, Erasmus MC University Medical Center Rotterdam, Rotterdam,

The Netherlands.AbstractSummary.  Flares in chronic hepatitis B are often

detrimental but sometimes lead to sustained immune control and disease

remission. The aim of this study was to estimate the frequency of hepatitis

flares which occur during and/or after cessation of nucleos(t)ide analogue (NA)

therapy, and to assess their outcomes. In a single centre cohort study we

investigated 227 patients who received a total of 351 NA treatment courses. NA

therapy was discontinued after 149 treatment courses. In total, 27 flares were

observed during 9779 on-treatment patient-months. The frequency was estimated as

3.2 per 100 person-years (95% CI 2.2-4.7). Lamivudine (LAM)-treated patients

demonstrated the highest frequency (4.9/100 person-years, 95% CI 3.2-7.4).

Twenty (74%) of 27 on-therapy flares were associated with development of

genotypic resistance, which all occurred during LAM therapy. NA withdrawal

flares occurred after a median post-treatment follow-up of 3.5 months in 17

(11%) of 149 treatment discontinuations. No flares were observed in patients who

switched to another antiviral agent (n = 51). None of the on-therapy and

withdrawal flares related to NA therapy were associated with sustained disease

remission, and seven flares resulted in decompensated liver disease. In this

study, flares related to NA therapy never led to immune control and sustained

disease remission, and sometimes resulted in decompensated liver disease.© 2011

Blackwell Publishing Ltd.PMID: 21692940 [PubMed - in process]