title: Serum hepatitis B surface antigen monitoring in long-term lamivudine-treated hepatitis B virus patients.
abstract: Serum hepatitis B virus surface antigen (HBsAg) levels have been suggested to predict interferon response in chronic hepatitis B. A few data are available on the role of HBsAg measurement in nucleos(t)ide analogues (NA) treatment. We retrospectively investigated the relation between HBsAg changes and main treatment outcomes during long-term lamivudine treatment in hepatitis e antigen (HBeAg)-negative chronic hepatitis B. A total of 42 HBeAg-negative patients were consecutively enrolled in an open-label study on long-term lamivudine monotherapy (150 mg/die). Serum HBsAg levels were quantified every 6 months by Architect assay (Abbott Diagnostics). HBV-DNA was quantified quarterly by real-time PCR (Roche Diagnostics). The median duration of lamivudine treatment was 66 months (20-153). One patient (2%) was a primary nonresponder, 35 (83%) developed virological breakthrough (VB) and the remaining six patients (14%) were classified as long-term on-treatment responders. During treatment, HBsAg levels decreased only in long-term on-treatment responders, while no changes were observed in resistant patients. Failure to achieve a decrease of 0.7 log(10) IU/mL in serum HBsAg at month six of lamivudine had a positive predictive value of developing VB of 90% and a negative predictive value of 100%. These high predictive values were also maintained in the subgroup of patients negative for HBV-DNA at month six. The results of this study with a small sample size suggest a role of on-treatment HBsAg quantification in the management of lamivudine-treated patients. If validated prospectively in a larger patient cohort, HBsAg measurements would be a useful adjunct to optimize antiviral therapy.
authors.affiliation: Department of Clinical Medicine, University of Bologna, Bologna, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Gramenzi
authors.forename: E
authors.initials: E
authors.lastname: Loggi
authors.forename: L
authors.initials: L
authors.lastname: Micco
authors.forename: C
authors.initials: C
authors.lastname: Cursaro
authors.forename: S
authors.initials: S
authors.lastname: Fiorino
authors.forename: S
authors.initials: S
authors.lastname: Galli
authors.forename: S
authors.initials: S
authors.lastname: Gitto
authors.forename: C
authors.initials: C
authors.lastname: Galli
authors.forename: G
authors.initials: G
authors.lastname: Furlini
authors.forename: M
authors.initials: M
authors.lastname: Bernardi
authors.forename: P
authors.initials: P
authors.lastname: Andreone
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage*; D004279:DNA, Viral / Q000097:blood; D016903:Drug Monitoring / Q000379:methods*; D005260:Female; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D019259:Lamivudine / Q000008:administration & dosage*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D060888:Real-Time Polymerase Chain Reaction; D012189:Retrospective Studies; D044967:Serum / Q000737:chemistry; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D019259:Lamivudine