國家衛生研究院 NHRI:Item 3990099045/10254
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    Please use this identifier to cite or link to this item: http://ir.nhri.org.tw/handle/3990099045/10254


    Title: Serum viral load at the virological relapse predicts subsequent clinical flares in chronic hepatitis B patients off entecavir therapy
    Authors: Hsu, YC;Mo, LR;Chang, CY;Wu, MS;Yang, TH;Kao, JH;Chen, CC;Tseng, CH;Tai, CM;Lin, CW;Wu, CY;Lin, JT
    Contributors: National Institute of Cancer Research
    Abstract: BACKGROUND: Therapeutic duration of nucleos(t)ide analogues for chronic hepatitis B (CHB) is not indefinite in many parts of the world. Viral reactivation is common off therapy but the risk of subsequent clinical outcome remains unclear and unpredictable. AIM: We aimed to quantify the incidence of and explore the predictors for clinical flare following virological relapse in CHB patients who discontinue entecavir therapy. METHODS: This multicenter cohort study prospectively monitored 133 CHB patients who were HBeAg-negative and viral DNA-undetectable when discontinuing entecavir after at least 3 years on therapy. Following virological relapse (viral DNA >2,000 IU/mL) that occurred in 92 patients, the incidences of subsequent clinical flare and persistent (unremittent for 3 months) or severe hepatitis (with jaundice or coagulopathy) were determined, and risk factors were explored. Patients did not resume antiviral therapy until occurrence of persistent or severe hepatitis. RESULTS: The cumulative incidence of clinical hepatitis 2 years after virological relapse was 61.0% (95% CI, 49.9-72.3%) and that of persistent or severe hepatitis was 53.0% (95% CI, 40.9-66.2%). Serum viral load at the virological relapse was associated with both clinical hepatitis (adjusted hazard ratio [HR], 1.31 per log IU/mL; 95% CI, 1.07-1.60) and persistent or severe hepatitis (adjusted HR, 1.63 per log IU/mL; 95% CI, 1.27-2.10), after adjustment for serum aminotransferase and alfa-fetoprotein levels in the multivariate analysis. Viral DNA >100,000 IU/mL predicted a nearly inevitable occurrence of clinical flare (P < 0.0001). CONCLUSIONS: A high viral load at the virological relapse predicts subsequent clinical hepatitis in CHB patients who discontinue entecavir.
    Date: 2017-08
    Relation: Journal of Gastroenterology and Hepatology. 2017 Aug;32(8):1512-1519.
    Link to: http://dx.doi.org/10.1111/jgh.13728
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0815-9319&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000406478400018
    Cited Times(Scopus): https://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85026327277
    Appears in Collections:[Others] Periodical Articles

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