In:
Journal of Gastroenterology and Hepatology, Wiley, Vol. 33, No. 10 ( 2018-10), p. 1766-1772
Abstract:
This study investigated whether hepatitis B surface antigen (HBsAg) could predict hepatitis B virus (HBV) relapse after cessation of entecavir or tenofovir disoproxil fumarate (TDF) prophylaxis for chronic hepatitis B cancer patients who are undergoing chemotherapy. Methods The study enrolled 122 hepatitis B e‐antigen‐negative cancer patients who underwent chemotherapy with entecavir or TDF for antiviral prophylaxis and posttreatment follow‐up for at least 6 months. Results Of the 122 patients, 52 and 18 experienced virological and clinical relapse, which had 3‐year cumulative incidences of 46.6% and 18.6%, respectively. Multivariate analysis showed that end‐of‐treatment HBsAg levels and baseline HBV‐DNA ≥ 2000 IU/mL were independent predictors of virological relapse. The best HBsAg cutoff value was 500 IU/mL. An end‐of‐treatment HBsAg of 500 IU/mL was useful for predicting virological relapse in patients with baseline HBV‐DNA 〈 2000 IU/mL (3‐year rate: 21.3% vs 46.4%, P = 0.038, in patients with HBsAg 〈 500 and ≥ 500 IU/mL, respectively), but not in patients with baseline HBV‐DNA ≥ 2000 IU/mL. Of the 52 patients who experienced virological relapse, 13 experienced transient virological relapse. Patients with baseline HBV‐DNA level 〈 2000 IU/mL experienced a higher rate of transient virological relapse (42.1% vs 15.2%, P = 0.031). Three patients experienced hepatic decompensation upon alanine aminotransferase flares, and no patient died after timely retreatment. Ten patients experienced posttreatment HBsAg loss, and the 3‐year HBsAg loss rate was 30.7% in patients with end‐of‐treatment HBsAg 〈 100 IU/mL. Conclusions The baseline HBV‐DNA and end‐of‐treatment HBsAg levels could predict virological relapse after withdrawal of entecavir and TDF prophylaxis for chemotherapy.
Type of Medium:
Online Resource
ISSN:
0815-9319
,
1440-1746
DOI:
10.1111/jgh.2018.33.issue-10
Language:
English
Publisher:
Wiley
Publication Date:
2018
detail.hit.zdb_id:
2006782-3
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