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Dynamics of hepatitis B e antigen index ratio correlate with treatment response in chronic hepatitis B patients

Authors

  • Chia-Chi Wang,

    1. Department of Internal Medicine, Division of Hepatogastroenterology, Buddhist Xindian Tzu Chi General Hospital, Taipei, Taiwan
    2. Department of Internal Medicine, Min-Sheng General Hospital, Taipei, Taiwan
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  • Chun-Jen Liu,

    1. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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  • Ming-Yang Lai,

    1. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
    2. Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
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  • Jia-Horng Kao,

    1. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
    2. Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
    3. Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan
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  • Ding-Shinn Chen

    1. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Correspondence
Jia-Horng Kao MD, PhD, Director and Professor, Hepatitis Research Center, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan.
Tel: +886 223 123 456 ext 7307
Fax: +886 223 825 962
e-mail: kjh@ha.mc.ntu.edu.tw

Abstract

Background/Aim: Hepatitis B e antigen (HBeAg) seroconversion is an important event in the natural history of chronic hepatitis B virus (HBV) infection. Whether early dynamics of HBeAg index ratio could predict therapeutic endpoint of HBeAg seroconversion in patients receiving lamivudine remains unclear and thus deserves investigation.

Methods: A total of 52 patients (males/females, 40/12; mean age, 31.1±7.5 years) with HBeAg-positive chronic hepatitis B and serum alanine aminotransferase (ALT) level ≥5 × upper limit of normal were enrolled. They received daily 100 mg lamivudine for at least 1 year. Pretreatment HBeAg index ratio and the dynamics during treatment [early serologic response (ESR) and serologic breakthrough (SB)] between responders and non-responders were compared.

Results: Of these 52 patients, mean pretreatment serum ALT level was 580 IU/l and baseline HBeAg index ratio (S/N) was 37.9. The overall 1-year on-treatment combined response rate was 50%. By using linear regression analysis, HBeAg index ratio was positively correlated with serum HBV DNA level (Pearson's correlation coefficient: 0.62, P<0.0001). By using multivariate logistic regression analysis, ESR could predict the success of treatment response (P=0.0302), and SB had a 90% positive predictive value of treatment failure.

Conclusions: HBeAg index ratio is closely correlated with serum HBV DNA level, and the dynamics of HBeAg index ratio may predict 1-year on-treatment combined response to lamivudine in HBeAg-positive chronic hepatitis B patients.

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