title: HBV DNA loss within 24 weeks predicts late viral breakthrough in chronic hepatitis B.
abstract: OBJECTIVE
  Sustained HBV DNA reduction is necessary for biochemical remission, histological improvement, and prevention of complications. We analyzed the time taken from HBV DNA loss to viral breakthrough after antiviral treatment in patients with chronic hepatitis B (CHB). The early fall of the HBV DNA level to undetectable levels assessed really whether it is related to late breakthrough.
  
  
  METHODS
  A total of 91 patients whose HBV DNA levels dropped below undetectable levels were chosen from lamivudine-treated 306 patients and were analyzed retrospectively. The patients were divided into 4 groups (A≤12, 12<B≤24, 24<C≤48, D>48 wk) according to the time taken for the HBV DNA to decrease below undetectable levels. HBV DNA level was determined every 3 months.
  
  
  RESULTS
  The mean time taken for loss of HBV DNA was 34±28 wk. The baseline ALT differed significantly among groups (A: 382±274, B: 340±30, C: 166±92, D: 54±100 IU/L) (p=0.007). Fifty nine of the 91 patients (64.8%) experienced viral breakthrough. The mean interval between HBV DNA loss and viral breakthrough was 65±40 wk and differed significantly between group A, B (82±43 wk) and group C, D (56±28 wk) (p=0.015). In multivariate analysis, only HBV DNA loss within 24 wk, was found to be independently associated with late viral breakthrough (p=0.035). Undetectable HBV DNA after 24 wk was associated with high odd ratio of 3.24 (95% CI, 1.09-9.67).
  
  
  CONCLUSIONS
  HBV DNA loss within 24 wk after antiviral treatment could predict the late breakthrough.
authors.affiliation: Institute for Digestive Research, Department of Internal Medicine, Soonchunhyang University Hospital, Seoul, Korea.
authors.forename: Seong Ran
authors.initials: SR
authors.lastname: Jeon
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Jang
authors.forename: Soung Won
authors.initials: SW
authors.lastname: Jeong
authors.forename: Seung Hoon
authors.initials: SH
authors.lastname: Park
authors.forename: Sae Hwan
authors.initials: SH
authors.lastname: Lee
authors.forename: Sang Gyune
authors.initials: SG
authors.lastname: Kim
authors.forename: Young Koog
authors.initials: YK
authors.lastname: Cheon
authors.forename: Young Seok
authors.initials: YS
authors.lastname: Kim
authors.forename: Young Deok
authors.initials: YD
authors.lastname: Cho
authors.forename: Jong Ho
authors.initials: JH
authors.lastname: Moon
authors.forename: Hong Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Joon Seong
authors.initials: JS
authors.lastname: Lee
authors.forename: Boo Sung
authors.initials: BS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use; D001219:Aspartate Aminotransferases / Q000097:blood; D004279:DNA, Viral / Q000097:blood; D004334:Drug Administration Schedule; D005260:Female; D006515:Hepatitis B virus / Q000302:isolation & purification*; D019694:Hepatitis B, Chronic / Q000188:drug therapy / Q000821:virology*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012189:Retrospective Studies
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D019259:Lamivudine; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase