Quantitative
HBV
DNA
Levels
Are
an
Early
Predictor
of
Nonresponse
in
Chronic
HBe-Antigen
Positive
Hepatitis
B Patients
Treated
with
Interferon-alfa To
reduce
unnecessary
and
potentially
harmful
exposure
to
treatment
with
interferon
alfa,
physicians
must
decide
at
an
early
stage
whether
continuation
of
treatment
has
a reasonable
chance
of
success
for
the
individual
patient.
The
objectives
of
the
current
study
were
to
evaluate
quantitative
hepatitis
B e
antigen
(HBeAg)
measurements
vs
quantitative
hepatitis
B virus
(HBV)
DNA
measurements
for
prediction
of
nonresponse
and
response
in
interferon
(IFN)-alfa-
treated
HBeAg
positive
chronic
HBV
patients.
Serum
HBV
DNA
and
HBeAg
levels
were
assessed
at
baseline
and
weeks
8 and
12.
For
each
test
(HBV
DNA
level
at
baseline,
HBV
DNA
decrease
between
baseline
and
weeks
8 and
12,
or
the
combination
of
these
two,
as
well
as
HBeAg
level
at
baseline,
HBeAg
decrease
between
baseline
and
weeks
8 and
12,
and
the
combination
of
these
two),
the
researchers
calculated
the
positive
predictive
value,
negative
predictive
value,
sensitivity
and
specificity.
Monitoring
with
quantitative
HBV
DNA
levels
was
superior
to
monitoring
with
quantitative
HBeAg
levels.
Step-wise
logistic
regression
identified
HBV
DNA
at
baseline
and
decrease
in
HBV
DNA
from
baseline
to
week
12,
as
independent
predictors
of
response.
The
overall
test
performance
of
predicting
nonresponse
(predictive
value
100%)
was
best
for
log
HBV
DNA
testing
at
week
12
compared
with
testing
at
week
8 due
to
a better
prediction
of
sustained
response
(46%vs
38%)
and
lower
misidentification
of
nonresponse
(39%vs
54%).
In
conclusion,
the
authors
write,
"This
study
shows
that
quantitative
HBV
DNA
testing
at
baseline
in
combination
with
a decrease
between
baseline
and
week
12
has
a high
predictive
value
for
identifying
patients
who
have
virtually
no
chance
of
reaching
a sustained
response
with
IFN
therapy."
03/17/06 Reference
A
van
der
Eijk
and
others.
Quantitative
HBV
DNA
levels
as
an
early
predictor
of
nonresponse
in
chronic
HBe-antigen
positive
hepatitis
B patients
treated
with
interferon-alpha.
Journal
of
Viral
Hepatitis
13
(2):
96-103.
February
2006.
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