Academic Journal
Week 4 viral load predicts long‐term suppression of hepatitis B virus DNA during antiviral therapy: improving hepatitis B treatment in the real world
| العنوان: | Week 4 viral load predicts long‐term suppression of hepatitis B virus DNA during antiviral therapy: improving hepatitis B treatment in the real world |
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| المؤلفون: | Truong, J., Shadbolt, B., Ooi, M., Chitturi, S., Kaye, G., Farrell, G. C., Teoh, N. C. |
| المصدر: | Internal Medicine Journal ; volume 47, issue 1, page 50-56 ; ISSN 1444-0903 1445-5994 |
| بيانات النشر: | Wiley |
| سنة النشر: | 2017 |
| المجموعة: | Wiley Online Library (Open Access Articles via Crossref) |
| الوصف: | Background Entecavir and tenofovir potently suppress hepatitis B virus ( HBV ) replication so that serum HBV DNA levels <20 IU / mL can be achieved after 2 years. Despite this, inadequate suppression is reported in >20% of cases for unclear reasons. Aim We tested whether 4‐week viral load ( VL ) assessment could improve 96‐week treatment outcome. Methods Data on all chronic hepatitis B patients treated with entecavir or tenofovir between 2005 and 2014 were entered prospectively. Full data capture included pre‐treatment, weeks 4, 24, 48 and 96 HBV DNA titre, HBeAg , age, gender, antiviral agent and dose escalation. Compliance data were compiled from pharmacy records, doctors’ letters and clinic bookings/attendance. Time to achieve complete viral suppression ( HBV DNA < 20 IU / mL ) was graphed using Kaplan–Meier curves. Factors affecting this were examined using a multivariate Cox Proportional Hazard model. Results Among 156 patients treated, 72 received entecavir and 84 tenofovir. Pre‐treatment HBV DNA titre, 4‐week assessment and compliance impacted significantly on time to complete viral suppression. At 96 weeks, 90% of those assessed as compliant by 4‐week HBV DNA had complete viral suppression versus 50% followed by 6‐month VL estimation. Continuing care by the same physician was related to 4‐week VL testing and optimal compliance. Conclusions Medium‐term outcomes of HBV antiviral therapy are improved by early on‐treatment VL testing, facilitating patient engagement and improved compliance. The observation that 90% complete viral suppression after 2 years monotherapy is achievable in a routine clinic setting questions the need for combination therapy in HBV cases with suboptimal response. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1111/imj.13244 |
| الاتاحة: | http://dx.doi.org/10.1111/imj.13244 https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Fimj.13244 https://onlinelibrary.wiley.com/doi/pdf/10.1111/imj.13244 |
| Rights: | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| رقم الانضمام: | edsbas.D6765BD3 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1111/imj.13244 |
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