Association of Hepatitis B Core-Related Antigen With Hepatitis B Virus Reactivation in Occult Viral Carriers Undergoing High-Risk Immunosuppressive Therapy View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2016-09-20

AUTHORS

Wai-Kay Seto, DannyKa-Ho Wong, ThomasSau-Yan Chan, Yu-Yan Hwang, James Fung, Kevin Sze-Hang Liu, Harinder Gill, Yuk-Fai Lam, Ka-Shing Cheung, Albert K W Lie, Ching-Lung Lai, Yok-Lam Kwong, Man-Fung Yuen

ABSTRACT

OBJECTIVES: Hepatitis B core-related antigen (HBcrAg) is a novel serum marker that correlates with intrahepatic hepatitis B virus (HBV) activity. Its association with HBV reactivation in hepatitis B surface antigen (HBsAg)-negative antibody to hepatitis B core antigen (anti-HBc)-positive patients undergoing high-risk immunosuppressive therapy is undefined. METHODS: HBcrAg was measured in HBsAg-negative, anti-HBc-positive Asian patients with undetectable HBV DNA, who participated in two prospective studies investigating HBV reactivation during rituximab-containing chemotherapy and allogeneic hematopoietic stem cell transplantation (HSCT). Patients were monitored every 4 weeks for up to 2 years, with entecavir started when HBV reactivation, defined as HBV DNA ≥10 IU ml-1, developed. RESULTS: One hundred and twenty-four HBsAg-negative, anti-HBc-positive patients (rituximab, N=62; allogeneic HSCT, N=62) with a median follow-up of 64 weeks (range: 4-104 weeks) were studied. HBV reactivation occurred in 31 patients, with a 2-year cumulative reactivation rate of 40.4%. Serum HBcrAg was detected in 43 (34.7%) patients. Baseline HBcrAg positivity was significantly associated with HBV reactivation (P=0.004, hazard ratio (HR): 2.94, 95% confidence interval (95% CI): 1.43-6.07). HBcrAg-positive patients had a significantly higher 2-year HBV reactivation rate than HBcrAg-negative patients (71.8 vs. 31%, P=0.002). In the rituximab cohort, the HRs for positive HBcrAg and negative antibody to HBsAg for HBV reactivation were 3.65 and 2.84, respectively (P=0.011, 95% CI: 1.35-9.86 and P=0.032, 95% CI: 1.10-7.37, respectively). CONCLUSIONS: Serum HBcrAg positivity is a significant risk factor of HBV reactivation in HBsAg-negative, anti-HBc-positive patients undergoing high-risk immunosuppressive therapy and can potentially have a role in identifying patients who will best benefit from prophylactic nucleoside analogue treatment. More... »

PAGES

1788

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/ajg.2016.436

DOI

http://dx.doi.org/10.1038/ajg.2016.436

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1017059182

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/27644733


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33 schema:description OBJECTIVES: Hepatitis B core-related antigen (HBcrAg) is a novel serum marker that correlates with intrahepatic hepatitis B virus (HBV) activity. Its association with HBV reactivation in hepatitis B surface antigen (HBsAg)-negative antibody to hepatitis B core antigen (anti-HBc)-positive patients undergoing high-risk immunosuppressive therapy is undefined. METHODS: HBcrAg was measured in HBsAg-negative, anti-HBc-positive Asian patients with undetectable HBV DNA, who participated in two prospective studies investigating HBV reactivation during rituximab-containing chemotherapy and allogeneic hematopoietic stem cell transplantation (HSCT). Patients were monitored every 4 weeks for up to 2 years, with entecavir started when HBV reactivation, defined as HBV DNA ≥10 IU ml<sup>-1</sup>, developed. RESULTS: One hundred and twenty-four HBsAg-negative, anti-HBc-positive patients (rituximab, N=62; allogeneic HSCT, N=62) with a median follow-up of 64 weeks (range: 4-104 weeks) were studied. HBV reactivation occurred in 31 patients, with a 2-year cumulative reactivation rate of 40.4%. Serum HBcrAg was detected in 43 (34.7%) patients. Baseline HBcrAg positivity was significantly associated with HBV reactivation (P=0.004, hazard ratio (HR): 2.94, 95% confidence interval (95% CI): 1.43-6.07). HBcrAg-positive patients had a significantly higher 2-year HBV reactivation rate than HBcrAg-negative patients (71.8 vs. 31%, P=0.002). In the rituximab cohort, the HRs for positive HBcrAg and negative antibody to HBsAg for HBV reactivation were 3.65 and 2.84, respectively (P=0.011, 95% CI: 1.35-9.86 and P=0.032, 95% CI: 1.10-7.37, respectively). CONCLUSIONS: Serum HBcrAg positivity is a significant risk factor of HBV reactivation in HBsAg-negative, anti-HBc-positive patients undergoing high-risk immunosuppressive therapy and can potentially have a role in identifying patients who will best benefit from prophylactic nucleoside analogue treatment.
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40 B core antigen
41 B surface antigen
42 B virus reactivation
43 DNA
44 HBV DNA
45 HBV reactivation
46 HBV reactivation rate
47 HBcrAg
48 HBsAg
49 Hepatitis B Virus Activity
50 activity
51 allogeneic hematopoietic stem cell transplantation
52 analogue treatment
53 antibodies
54 antigen
55 association
56 carriers
57 cell transplantation
58 chemotherapy
59 cohort
60 core antigen
61 core-related antigen
62 entecavir
63 factors
64 hematopoietic stem cell transplantation
65 hepatitis B core antigen
66 hepatitis B core-related antigen
67 hepatitis B surface antigen
68 hepatitis B virus reactivation
69 hr
70 immunosuppressive therapy
71 markers
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73 novel serum marker
74 nucleoside analogue treatment
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76 positive patients
77 positivity
78 prospective study
79 rate
80 reactivation
81 reactivation rate
82 risk factors
83 rituximab cohort
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85 role
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88 significant risk factors
89 stem cell transplantation
90 study
91 surface antigen
92 therapy
93 transplantation
94 treatment
95 undetectable HBV DNA
96 viral carriers
97 virus activity
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99 weeks
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