Chronic hepatitis B prognostic markers other than pre-treatment viral load predicted composite treatment outcome

Authors

  • Myo Nyein Aung Graduate School of Medicine, Juntendo University,Tokyo, Japan
  • Wattana Leowattana Faculty of Tropical Medicine, Mahidol University, Thailand
  • Khine Nwe Win Faculty of Tropical Medicine, Mahidol University, Thailand
  • Noppadon Tangpukdee Faculty of Tropical Medicine, Mahidol University, Thailand
  • Sant Muangnoicharoen Faculty of Tropical Medicine, Mahidol University, Thailand

DOI:

https://doi.org/10.3855/jidc.2759

Keywords:

chronic hepatitis B, predictors, treatment outcome

Abstract

Introduction: Chronic hepatitis B (CHB) is a globally common infectious disease. Its clinical course is complicated. In Southeast Asia, nucleos(t)ide analogues (NA) are commonly used drugs for CHB treatment. Composite treatment outcome has often been used in CHB clinical practice, but rarely predicted epidemiologically. This study aimed to compare the composite treatment outcome between CHB patients with low and high treatment-naïve viral load, and to identify its predictors

Methodology: This retrospective cohort study followed up 95 CHB patients on NA treatment for a year. Composite treatment outcome was defined as undetectable HBV DNA level, ALT normalization and, HBeAg clearance in the case of HBeAg-positive patients. Multinomial logistic regression analysis was applied to analyze the significant treatment response predictors.

Results: Complete composite treatment outcome was achieved by 52% of CHB patients with an initial viral load < 6.5 log 10 copies /ml, but 31% of those had an initial viral load ≥ log 6.5 log 10 copies /ml. Outcome was predicted by HBeAg negativity (adjusted relative risk ratio, aRRR = 11.1, 95 % confidence interval, CI 3-41.3) and ALT normalization within the sixth month of therapy (aRRR = 6.7, CI 1.8-24.9). An elevation of ALT to more than 1.5 times the normal value (40 IU/ml) can lead to an incomplete response on NA therapy (aRRR = 6.2, CI 1.5-26.6.)

Conclusion: Routine clinical markers other than pre-treatment viral load predicted composite CHB outcome on NA Therapy.

Author Biographies

Myo Nyein Aung, Graduate School of Medicine, Juntendo University,Tokyo, Japan

Collaborative fellow researcher, Department of Public Health, School of Medicine, Juntendo University, Tokyo, Japan Responsibility:  (1) to design, register and publish the protocol of cluster randomized trial of salt reduction, smoking cessation trial for prevention of cardiovascular disease and implementation, (2) International registration of Protocol and (3) Publication of research findinghttp://www.controlled-trials.com/ISRCTN39416277/

Wattana Leowattana, Faculty of Tropical Medicine, Mahidol University, Thailand

Associate professorDepartment of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Thailand

Khine Nwe Win, Faculty of Tropical Medicine, Mahidol University, Thailand

General practitioner

Noppadon Tangpukdee, Faculty of Tropical Medicine, Mahidol University, Thailand

Assistant professor

Sant Muangnoicharoen, Faculty of Tropical Medicine, Mahidol University, Thailand

Lecturer

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Published

2013-07-15

How to Cite

1.
Aung MN, Leowattana W, Win KN, Tangpukdee N, Muangnoicharoen S (2013) Chronic hepatitis B prognostic markers other than pre-treatment viral load predicted composite treatment outcome. J Infect Dev Ctries 7:541–549. doi: 10.3855/jidc.2759

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Section

Original Articles