Profiles of HBV DNA in a large population of Chinese patients with chronic hepatitis B: Implications for antiviral therapy

[Guest guest]

http://www.sciencedirect.com/science?_ob=ArticleURL & _udi=B6W7C-50XS692-1 & _user=1\

0 & _coverDate=02%2F28%2F2011 & _rdoc=10 & _fmt=high & _orig=browse & _origin=browse & _zone\

=rslt_list_item & _srch=doc-info(%23toc%236623%232011%23999459997%232863736%23FLA%\

23display%23Volume) & _cdi=6623 & _sort=d & _docanchor= & _ct=40 & _acct=C000050221 & _versi\

on=1 & _urlVersion=0 & _userid=10 & md5=bf33ddcd6d8ce7b008ff452ac565c1ca & searchtype=a

Journal of Hepatology

Volume 54, Issue 2, February 2011, Pages 195-200

doi:10.1016/j.jhep.2010.06.031 | How to Cite or Link Using DOI

European Association for the Study of the Liver Published by

Elsevier Ireland Ltd.

Research Article

Profiles of HBV DNA in a large population of Chinese patients with chronic

hepatitis B: Implications for antiviral therapy

References and further reading may be available for this article. To view

references and further reading you must purchase this article.

Funga, Wai-Kay Setoa, Ching-Lung Laia, Yuena, Danny Ka-Ho Wonga and

Man-Fung Yuen, a,

a Department of Medicine, The University of Hong Kong, Queen Hospital, Hong

Kong SAR, Hong Kong

Received 19 January 2010;

revised 6 June 2010;

accepted 30 June 2010.

Available online 3 September 2010.

Background & Aims

We determined the virological profile in Chinese chronic hepatitis B (CHB)

subjects and its implications regarding current treatment guidelines.

Methods

A total of 1400 treatment-naïve CHB patients had their HBV DNA levels determined

using the Cobas Taqman assay. Patient demographics, HBeAg status, and liver

biochemistry were also recorded.

Results

The subjects were predominantly male (62%), had a median age of 45 years, and

301 (22%) were HBeAg-positive. In subjects aged 25, 26–35, 36–45, 46–55, and >55

years, there was a decreasing trend of HBV DNA levels of 9.9, 9.3, 8.2, 7.4, and

7.3 log copies/ml, respectively (p <0.001), in HBeAg-positive subjects, while

the pattern was reversed with HBV DNA levels of 3.7, 4.4, 4.7, 4.9, and 5.2 log

copies/ml, respectively, in HBeAg-negative subjects (p <0.001). In

HBeAg-negative subjects, the proportion of patients with elevated ALT compared

to those with normal ALT was significantly higher in older age groups (p

<0.001). In our study population, by applying the AASLD, EASL, and APASL

guidelines, 64%, 99%, and 64% would be eligible for antiviral therapy,

respectively, in HBeAg-positive patients (with elevated ALT), and 38%, 72%, and

43%, respectively, in HBeAg-negative patients (with elevated ALT). Up to 54% of

patients over the age of 40 years would be recommended for liver biopsy to

determine further eligibility for treatment.

Conclusions

For HBeAg-negative CHB, more patients had elevated ALT and a higher viral load

with increasing age. Close monitoring is recommended in this group so that

treatment may be considered. By applying the current treatment guidelines, a

wide discrepancy can be observed in the proportion of patients eligible for

treatment in the absence of histological data.

[Guest guest]

http://www.sciencedirect.com/science?_ob=ArticleURL & _udi=B6W7C-50XS692-1 & _user=1\

0 & _coverDate=02%2F28%2F2011 & _rdoc=10 & _fmt=high & _orig=browse & _origin=browse & _zone\

=rslt_list_item & _srch=doc-info(%23toc%236623%232011%23999459997%232863736%23FLA%\

23display%23Volume) & _cdi=6623 & _sort=d & _docanchor= & _ct=40 & _acct=C000050221 & _versi\

on=1 & _urlVersion=0 & _userid=10 & md5=bf33ddcd6d8ce7b008ff452ac565c1ca & searchtype=a

Journal of Hepatology

Volume 54, Issue 2, February 2011, Pages 195-200

doi:10.1016/j.jhep.2010.06.031 | How to Cite or Link Using DOI

European Association for the Study of the Liver Published by

Elsevier Ireland Ltd.

Research Article

Profiles of HBV DNA in a large population of Chinese patients with chronic

hepatitis B: Implications for antiviral therapy

References and further reading may be available for this article. To view

references and further reading you must purchase this article.

Funga, Wai-Kay Setoa, Ching-Lung Laia, Yuena, Danny Ka-Ho Wonga and

Man-Fung Yuen, a,

a Department of Medicine, The University of Hong Kong, Queen Hospital, Hong

Kong SAR, Hong Kong

Received 19 January 2010;

revised 6 June 2010;

accepted 30 June 2010.

Available online 3 September 2010.

Background & Aims

We determined the virological profile in Chinese chronic hepatitis B (CHB)

subjects and its implications regarding current treatment guidelines.

Methods

A total of 1400 treatment-naïve CHB patients had their HBV DNA levels determined

using the Cobas Taqman assay. Patient demographics, HBeAg status, and liver

biochemistry were also recorded.

Results

The subjects were predominantly male (62%), had a median age of 45 years, and

301 (22%) were HBeAg-positive. In subjects aged 25, 26–35, 36–45, 46–55, and >55

years, there was a decreasing trend of HBV DNA levels of 9.9, 9.3, 8.2, 7.4, and

7.3 log copies/ml, respectively (p <0.001), in HBeAg-positive subjects, while

the pattern was reversed with HBV DNA levels of 3.7, 4.4, 4.7, 4.9, and 5.2 log

copies/ml, respectively, in HBeAg-negative subjects (p <0.001). In

HBeAg-negative subjects, the proportion of patients with elevated ALT compared

to those with normal ALT was significantly higher in older age groups (p

<0.001). In our study population, by applying the AASLD, EASL, and APASL

guidelines, 64%, 99%, and 64% would be eligible for antiviral therapy,

respectively, in HBeAg-positive patients (with elevated ALT), and 38%, 72%, and

43%, respectively, in HBeAg-negative patients (with elevated ALT). Up to 54% of

patients over the age of 40 years would be recommended for liver biopsy to

determine further eligibility for treatment.

Conclusions

For HBeAg-negative CHB, more patients had elevated ALT and a higher viral load

with increasing age. Close monitoring is recommended in this group so that

treatment may be considered. By applying the current treatment guidelines, a

wide discrepancy can be observed in the proportion of patients eligible for

treatment in the absence of histological data.