In:
Journal of Viral Hepatitis, Wiley, Vol. 16, No. 12 ( 2009-12), p. 876-882
Abstract:
Summary. Pretreatment alanine transaminase (ALT) elevation may be used as a predictor for higher hepatitis B e antigen (HBeAg) seroconversion in chronic hepatitis B patients. However, the role of dynamic changes of on‐treatment ALT for seroconversion is unknown. A total of 170 naïve HBeAg‐positive chronic hepatitis B patients were treated with a nucleoside/nucleotide analogues (NA), either lamivudine, adefovir, entecavir, or telbivudine, for at least 2 years and followed up for 1 more year. Clinical characteristics were detected and analysed at baseline and at 3‐month intervals. On‐treatment ALT predicted HBeAg seroconversion more accurately than baseline ALT. Among the patients with on‐treatment ALT ≤1 × UNL, 1–≤2 × UNL, 2–≤5 × UNL and 〉 5 × UNL, HBeAg seroconversion was 11.4, 5.4, 24.4 and 65.0% (odds ratio = 1.0, 0.4, 2.5 and 14.4, respectively), respectively. Moreover, two models/types of seroconversion were observed. Type I was characterized by rapidly decreased ALT and HBV DNA during the first 3‐month interval, but with high HBeAg reversion rate (50%) after consolidation treatment. Type II was a slow decreased DNA procedure accompanied by significant elevated ALT with less reversion (23%). Receiver operating characteristic curve analysis showed a 1.9‐fold increased ALT ratio (present visit ALT: previous visit ALT) accompanied by at least a 0.8 log decreased HBV DNA may be used to classify these two seroconversion types. We conclude that on‐treatment elevated ALT levels is a better predictor for seroconversion after NAs treatment, and HBV DNA profiles may help to identify different models of seroconversion.
Type of Medium:
Online Resource
ISSN:
1352-0504
,
1365-2893
DOI:
10.1111/jvh.2009.16.issue-12
DOI:
10.1111/j.1365-2893.2009.01145.x
Language:
English
Publisher:
Wiley
Publication Date:
2009
detail.hit.zdb_id:
2007924-2
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