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HBV seroclearance rare in Asians, women, younger patients
About 0.31% of patients with hepatitis B virus infection in the United States reached seroclearance of hepatitis B surface antigen annually, whereas only 1.2% of patients were cured, according to recent study data.
“Our work is believed to be the largest of its kind in North America. In this large, multiethnic study of real-world chronic hepatitis B patients, hepatitis B ‘cure rates’ were much lower than anticipated, particularly in Asian, female, and younger patients,” Long H. Nguyen, MD, internist at Stanford University Medical Center, and Mindie H. Nguyen, MD, MAS, AGAF, FAASLD, senior author and director of the hepatology fellowship and liver transplant program at Stanford, told Infectious Disease News.
Mindie H. Nguyen
The researchers retrospectively analyzed medical records of 4,737 patients with chronic HBV from five primary care, gastroenterology and multispecialty centers, and a university medical center, from 2001 to 2014. The researchers determined seroclearance of the infection by loss of hepatitis B surface antigen (HBsAg) positivity.
Fifty-two patients across 16,844 person-years (0.31% annually, 1.2% overall) experienced HBsAg seroclearance. HBsAg seroclearance was greater in patients of non-Asian descent, aged older than 45 years, males and those with baseline HBV DNA less than 10 000 IU/mL.
Multivariate Cox analysis showed non-Asian ethnicity (HR = 2.8; 95% CI, 1.2-6.5), male sex (HR = 2.1; 95% CI, 1.1-4) and aged older than 45 years (HR = 1.8; 95% CI, 1.02-3.35) were independent predictors of HBV seroclearance. High baseline HBV DNA predicted failure to reach HBsAg seroclearance (HR = 0.5; 95% CI, 0.3-0.9).
Long H. Nguyen
“These findings differ from the higher rates observed in prior clinical trials of carefully selected patients,” Long H. Nguyen said. “This suggests that the decision to treat is likely to involve a commitment to prolonged viral suppression therapy.
“Further research is needed to find therapies for which viral eradication, rather than control, are the priority.” – by Melinda Stevens
Disclosures: Long H. Nguyen reports no relevant financial disclosures. Mindie H. Nguyen reports receiving research support from Bristol-Myers Squibb and Gilead Sciences, and serving on the advisory boards at Alnylam Pharmaceuticals, Bristol-Myers Squibb, Gilead Sciences and Roche Laboratories.