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Drugs

, Volume 69, Issue 16, pp 2167–2177 | Cite as

Predictors of Treatment Response in Chronic Hepatitis B

  • Grace L.-H. Wong
  • Henry Lik-Yuen ChanEmail author
Leading Article

Abstract

The ultimate goal of treatment for chronic hepatitis B is to reduce liver-related complications and mortality. Sustained hepatitis B e antigen (HBeAg) seroconversion and hepatitis B surface antigen (HBsAg) clearance 6–12 months after stopping treatment are the short-term surrogate outcomes for interferon or peginterferon therapy. As most patients require long-term nucleos(t)ide analogue treatment, which also has the risk of drug resistance in the case of incomplete viral suppression, maintained hepatitis B virus (HBV) DNA suppression to an undetectable level is the appropriate surrogate outcome. Because no antiviral treatment is perfect, it is desirable for treatment response to be predicted and the treatment regimen modified accordingly. At baseline, high ALT and low HBV DNA levels can predict response to both (peg)interferon and nucleos(t)ide analogues. Genotype A HBV responds best to peginterferon but HBV genotype has no predictive value for nucleos(t)ide analogue treatment. HBV DNA is a good on-treatment predictor of response for nucleos(t)ide analogues but not for (peg)interferon. The data supporting the use of quantitative HBsAg and HBeAg to predict response to peginterferon is stronger than that for nucleos(t)ide analogues. In conclusion, predictors of response are useful to provide the most appropriate antiviral therapy to the most suitable patients, in order to achieve the best response and improve the clinical outcome of chronic hepatitis B patients.

Keywords

Sustained Virological Response HBeAg Seroconversion Adefovir Dipivoxil Telbivudine HBsAg Level 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

No sources of funding were used in the preparation of this article. Henry L.-Y. Chan is a member of the advisory boards of Novartis Pharmaceutics, Bristol-Myers Squibb and Pharmasset. Grace L.-H. Wong has no conflicts of interest that are directly relevant to the contents of this article

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Authors and Affiliations

  1. 1.Department of Medicine and Therapeutics and Institute of Digestive Disease, 9/F Prince of Wales HospitalThe Chinese University of Hong KongShatin, the Hong Kong SARChina

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