Sex Differences in Treatment Response to Nucleos(t)ide Therapy in Chronic Hepatitis B : A Multicenter Longitudinal Study
Copyright © 2024 AGA Institute. Published by Elsevier Inc. All rights reserved..
BACKGROUND & AIMS: It is unclear if there may be sex differences in response to nucleos(t)ide analogs including virologic response (VR), biochemical response (BR), complete response (CR), and hepatocellular carcinoma (HCC) incidence among hepatitis B patients. We compared nucleos(t)ide analog treatment outcomes by sex.
METHODS: We performed a retrospective cohort study of 3388 treatment-naïve adult hepatitis B patients (1250 female, 2138 male) from the Real-World Evidence from the Global Alliance for the Study of Hepatitis B Virus consortium who initiated therapy with either entecavir or tenofovir from 22 sites (Argentina, Korea, Japan, Taiwan, and the United States). We used propensity-score matching to balance background characteristics of the male and female groups and competing-risks analysis to estimate the incidence and subdistribution hazard ratios (SHRs) of VR, BR, CR, and HCC.
RESULTS: Females (vs males) were older (52.0 vs 48.6 y); less likely to be overweight/obese (49.3% vs 65.7%), diabetic (9.9% vs 13.1%), or cirrhotic (27.9% vs 33.0%); and had a lower HBV DNA level (5.9 vs 6.0 log10 IU/mL) and alanine aminotransferase level (91 vs 102 IU/L) (all P < .01). However, after propensity-score matching, relevant background characteristics were balanced between the 2 groups. Females (vs males) had similar 5-year cumulative VR (91.3% vs 90.3%; P = .40) and HCC incidence rates (5.1% vs 4.4%; P = .64), but lower BR (84.0% vs 90.9%; P < .001) and CR (78.8% vs 83.4%; P = .016). Males were more likely to achieve BR (SHR, 1.31; 95% CI, 1.17-1.46; P < .001) and CR (SHR, 1.16; 95% CI, 1.03-1.31; P = .016), but VR and HCC risks were similar.
CONCLUSIONS: Sex differences exist for treatment outcomes among hepatitis B patients. Male sex was associated with a 16% higher likelihood of clinical remission and a 31% higher likelihood of biochemical response than females, while virologic response and HCC incidence were similar between the 2 groups.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:22 |
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| Enthalten in: |
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association - 22(2024), 3 vom: 06. Feb., Seite 572-580.e5 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Chau, Angela [VerfasserIn] |
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| Links: |
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| Themen: |
Antiviral Agents |
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| Anmerkungen: |
Date Completed 26.02.2024 Date Revised 26.02.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.cgh.2023.09.002 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 245 | 1 | 0 | |a Sex Differences in Treatment Response to Nucleos(t)ide Therapy in Chronic Hepatitis B |b A Multicenter Longitudinal Study |
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| 500 | |a Date Revised 26.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2024 AGA Institute. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND & AIMS: It is unclear if there may be sex differences in response to nucleos(t)ide analogs including virologic response (VR), biochemical response (BR), complete response (CR), and hepatocellular carcinoma (HCC) incidence among hepatitis B patients. We compared nucleos(t)ide analog treatment outcomes by sex | ||
| 520 | |a METHODS: We performed a retrospective cohort study of 3388 treatment-naïve adult hepatitis B patients (1250 female, 2138 male) from the Real-World Evidence from the Global Alliance for the Study of Hepatitis B Virus consortium who initiated therapy with either entecavir or tenofovir from 22 sites (Argentina, Korea, Japan, Taiwan, and the United States). We used propensity-score matching to balance background characteristics of the male and female groups and competing-risks analysis to estimate the incidence and subdistribution hazard ratios (SHRs) of VR, BR, CR, and HCC | ||
| 520 | |a RESULTS: Females (vs males) were older (52.0 vs 48.6 y); less likely to be overweight/obese (49.3% vs 65.7%), diabetic (9.9% vs 13.1%), or cirrhotic (27.9% vs 33.0%); and had a lower HBV DNA level (5.9 vs 6.0 log10 IU/mL) and alanine aminotransferase level (91 vs 102 IU/L) (all P < .01). However, after propensity-score matching, relevant background characteristics were balanced between the 2 groups. Females (vs males) had similar 5-year cumulative VR (91.3% vs 90.3%; P = .40) and HCC incidence rates (5.1% vs 4.4%; P = .64), but lower BR (84.0% vs 90.9%; P < .001) and CR (78.8% vs 83.4%; P = .016). Males were more likely to achieve BR (SHR, 1.31; 95% CI, 1.17-1.46; P < .001) and CR (SHR, 1.16; 95% CI, 1.03-1.31; P = .016), but VR and HCC risks were similar | ||
| 520 | |a CONCLUSIONS: Sex differences exist for treatment outcomes among hepatitis B patients. Male sex was associated with a 16% higher likelihood of clinical remission and a 31% higher likelihood of biochemical response than females, while virologic response and HCC incidence were similar between the 2 groups | ||
| 650 | 4 | |a Multicenter Study | |
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| 700 | 1 | |a Kim, Sung Eun |e verfasserin |4 aut | |
| 700 | 1 | |a Trinh, Huy |e verfasserin |4 aut | |
| 700 | 1 | |a Yoon, Eileen L |e verfasserin |4 aut | |
| 700 | 1 | |a Oh, Hyunwoo |e verfasserin |4 aut | |
| 700 | 1 | |a Jeong, Jae Yoon |e verfasserin |4 aut | |
| 700 | 1 | |a Ahn, Sang Bong |e verfasserin |4 aut | |
| 700 | 1 | |a An, Jihyun |e verfasserin |4 aut | |
| 700 | 1 | |a Tseng, Cheng-Hao |e verfasserin |4 aut | |
| 700 | 1 | |a Hsu, Yao-Chun |e verfasserin |4 aut | |
| 700 | 1 | |a Jeong, Soung Won |e verfasserin |4 aut | |
| 700 | 1 | |a Cho, Yong Kyun |e verfasserin |4 aut | |
| 700 | 1 | |a Shim, Jae-Jun |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Hyoung Su |e verfasserin |4 aut | |
| 700 | 1 | |a Ito, Takanori |e verfasserin |4 aut | |
| 700 | 1 | |a Marciano, Sebastián |e verfasserin |4 aut | |
| 700 | 1 | |a Kawashima, Keigo |e verfasserin |4 aut | |
| 700 | 1 | |a Suzuki, Takanori |e verfasserin |4 aut | |
| 700 | 1 | |a Watanabe, Tsunamasa |e verfasserin |4 aut | |
| 700 | 1 | |a Nozaki, Akito |e verfasserin |4 aut | |
| 700 | 1 | |a Ishikawa, Toru |e verfasserin |4 aut | |
| 700 | 1 | |a Inoue, Kaori |e verfasserin |4 aut | |
| 700 | 1 | |a Eguchi, Yuichiro |e verfasserin |4 aut | |
| 700 | 1 | |a Uojima, Haruki |e verfasserin |4 aut | |
| 700 | 1 | |a Abe, Hiroshi |e verfasserin |4 aut | |
| 700 | 1 | |a Takahashi, Hirokazu |e verfasserin |4 aut | |
| 700 | 1 | |a Chuma, Makoto |e verfasserin |4 aut | |
| 700 | 1 | |a Ishigami, Masatoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Hoang, Joseph K |e verfasserin |4 aut | |
| 700 | 1 | |a Maeda, Mayumi |e verfasserin |4 aut | |
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