Early initiation of antiviral therapy contributes to a rapid and significant loss of serum HBsAg in infantile-onset hepatitis B
Copyright © 2019 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved..
BACKGROUND & AIM: There is a paucity of data regarding antiviral therapy in hepatitis B virus (HBV)-infected infants aged <1 year who have elevated alanine aminotransferase. This study aims to assess the efficacy and safety of antiviral therapy initiated in infancy.
METHODS: A real-world cohort study was conducted from January 2010 to December 2017. HBV-infected infants under 1 year of age, with persistent elevation of alanine aminotransferase and high viral load, were recruited and divided into 2 groups. Group I included 18 infants whose parents chose to initiate antiviral therapy with lamivudine before 1 year of age. Group II included 11 infants whose parents chose to initiate antiviral therapy with interferon-α after 1 year of age and not to receive any antiviral therapies before 1 year of age. The main outcome measure was rate of serum HBV surface antigen (HBsAg) loss at month 12 of treatment.
RESULTS: There were no statistical differences between Groups I and II regarding baseline characteristics. No infants in Group II developed spontaneous HBsAg loss before 1 year of age. In Group I, the cumulative rates of HBsAg loss at month 3, 6, 9 and 12 of treatment were 39%, 67%, 78% and 83%, respectively. In Group II, the cumulative rates of HBsAg loss at month 3, 6, 9 and 12 of treatment were 18%, 27%, 27% and 36%, respectively. Statistical differences existed in the cumulative rates of HBsAg loss between the 2 groups (log-rank test, p = 0.0023). No serious adverse events occurred in the study.
CONCLUSION: Early initiation of antiviral therapy for infantile-onset hepatitis B contributes to a rapid and significant loss of HBsAg. Further trials with larger cohorts are needed to verify our results.
LAY SUMMARY: Chronicity is a serious threat to infants infected with hepatitis B. However, no treatment measure has been recommended for infantile-onset hepatitis B in current guidelines. In order to evaluate the benefit and safety of antiviral therapy in infantile-onset hepatitis B, a real-world cohort study was conducted. Long-term follow-up results showed that early initiation of antiviral therapy with lamivudine safely led to a rapid and significant loss of serum hepatitis B surface antigen in the present subset of infants with alanine aminotransferase ≥2× upper limit of normal. Further trials with larger cohorts are needed.
| Errataetall: |
CommentIn: J Hepatol. 2019 Nov;71(5):856-858. - PMID 31506188 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:71 |
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| Enthalten in: |
Journal of hepatology - 71(2019), 5 vom: 07. Nov., Seite 871-875 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Zhu, Shishu [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 21.12.2020 Date Revised 22.01.2021 published: Print-Electronic CommentIn: J Hepatol. 2019 Nov;71(5):856-858. - PMID 31506188 Citation Status MEDLINE |
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| doi: |
10.1016/j.jhep.2019.06.009 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM298427141 |
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| 245 | 1 | 0 | |a Early initiation of antiviral therapy contributes to a rapid and significant loss of serum HBsAg in infantile-onset hepatitis B |
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| 500 | |a Date Completed 21.12.2020 | ||
| 500 | |a Date Revised 22.01.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: J Hepatol. 2019 Nov;71(5):856-858. - PMID 31506188 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2019 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved. | ||
| 520 | |a BACKGROUND & AIM: There is a paucity of data regarding antiviral therapy in hepatitis B virus (HBV)-infected infants aged <1 year who have elevated alanine aminotransferase. This study aims to assess the efficacy and safety of antiviral therapy initiated in infancy | ||
| 520 | |a METHODS: A real-world cohort study was conducted from January 2010 to December 2017. HBV-infected infants under 1 year of age, with persistent elevation of alanine aminotransferase and high viral load, were recruited and divided into 2 groups. Group I included 18 infants whose parents chose to initiate antiviral therapy with lamivudine before 1 year of age. Group II included 11 infants whose parents chose to initiate antiviral therapy with interferon-α after 1 year of age and not to receive any antiviral therapies before 1 year of age. The main outcome measure was rate of serum HBV surface antigen (HBsAg) loss at month 12 of treatment | ||
| 520 | |a RESULTS: There were no statistical differences between Groups I and II regarding baseline characteristics. No infants in Group II developed spontaneous HBsAg loss before 1 year of age. In Group I, the cumulative rates of HBsAg loss at month 3, 6, 9 and 12 of treatment were 39%, 67%, 78% and 83%, respectively. In Group II, the cumulative rates of HBsAg loss at month 3, 6, 9 and 12 of treatment were 18%, 27%, 27% and 36%, respectively. Statistical differences existed in the cumulative rates of HBsAg loss between the 2 groups (log-rank test, p = 0.0023). No serious adverse events occurred in the study | ||
| 520 | |a CONCLUSION: Early initiation of antiviral therapy for infantile-onset hepatitis B contributes to a rapid and significant loss of HBsAg. Further trials with larger cohorts are needed to verify our results | ||
| 520 | |a LAY SUMMARY: Chronicity is a serious threat to infants infected with hepatitis B. However, no treatment measure has been recommended for infantile-onset hepatitis B in current guidelines. In order to evaluate the benefit and safety of antiviral therapy in infantile-onset hepatitis B, a real-world cohort study was conducted. Long-term follow-up results showed that early initiation of antiviral therapy with lamivudine safely led to a rapid and significant loss of serum hepatitis B surface antigen in the present subset of infants with alanine aminotransferase ≥2× upper limit of normal. Further trials with larger cohorts are needed | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Antiviral therapy | |
| 650 | 4 | |a Hepatitis B virus | |
| 650 | 4 | |a Infant | |
| 650 | 4 | |a Lamivudine | |
| 650 | 4 | |a Real-word | |
| 650 | 4 | |a Treatment guidelines | |
| 650 | 7 | |a Antiviral Agents |2 NLM | |
| 650 | 7 | |a DNA, Viral |2 NLM | |
| 650 | 7 | |a Hepatitis B Surface Antigens |2 NLM | |
| 650 | 7 | |a Hepatitis B e Antigens |2 NLM | |
| 650 | 7 | |a Interferon-alpha |2 NLM | |
| 650 | 7 | |a Lamivudine |2 NLM | |
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| 700 | 1 | |a Dong, Yi |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Limin |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Weiwei |e verfasserin |4 aut | |
| 700 | 1 | |a Zhao, Pan |e verfasserin |4 aut | |
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