Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access
Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc
Journal website http://www.gastrores.org

Original Article

Volume 10, Number 1, February 2017, pages 6-14


Antiviral Therapy in Chronic Hepatitis B With Mild Acute Exacerbation

Figures

Figure 1.
Figure 1. The flowchart of the study design.
Figure 2.
Figure 2. The efficacy of pegIFN and NA treatments in HBeAg-positive CHB with mild AE. *P < 0.05, **P < 0.01,***P < 0.001.

Tables

Table 1. Annual Transition Probabilities by Initial State
 
Annual transitional probabilitiesEstimated (%)RangeReferences
HBsAg: hepatitis B surface antigen; HBeAg: hepatitis B envelope antigen; CHB: chronic hepatitis B; HCC: hepatocellular carcinoma.
From HBsAg clearance to[19]
  HCC0.039
From HBeAg Positive CHB to
  Spontaneous seroconversion7.02.0 - 23[18]
  Compensated cirrhosis2.42.1 - 2.6[18]
  HCC0.80.5 - 1.0[18]
  Death0.60.2 - 0.9[18]
From HBeAg seroconversion to
  HBsAg seroclearance0.70.4 - 1.2[18]
  Compensated cirrhosis1.00.1 - 6.3[18]
  HCC0.20.05 - 0.9[18]
From compensated cirrhosis to
  Decompensated cirrhosis3.93.2 - 4.6[18]
  HCC5.03.0 - 7.0[18]
  Death5.63.1 - 8.0[18]
From decompensated cirrhosis to
  HCC7.13.5 - 10.0[18]
  Death159.9 - 20.0[18]
From HCC to
  Death54.520.0 - 60.0[18]

 

Table 2. Annual Costs of Follow-Up or Treatment and Health State Utilities (Quality of Life) in Different Stages of Disease
 
Health state costs, RMB (Dollar) [18]Health state utilities [20]
HBsAg: hepatitis B surface antigen; HBeAg: hepatitis B envelope antigen; CHB: chronic hepatitis B; HCC: hepatocellular carcinoma.
HBsAg clearance110 ($19)0.99
HBeAg seroconversion110 ($19)0.95
HBeAg-positive CHB1,162 ($170)0.85
Compensated cirrhosis1,514 ($222)0.69
Decompensated cirrhosis13,927 ($2,040)0.35
HCC38,795 ($5,682)0.38

 

Table 3. The Baseline Characteristics and Outcomes of Acute Exacerbation Patients With Peginterferon α-2a or Nucleos(t)ide Analogues
 
Peginterferon α-2a (n = 63)Nucleos(t)ide analogues (n = 78)P value
HBsAg: hepatitis B surface antigen; HBeAg: hepatitis B envelope antigen; ALT: alanine aminotransferase. *Expressed as median (interquartile range).
Baseline
  Age (years)*25 (21 - 32)32 (26 - 35)< 0.001
  Male sex, n (%)49/63 (77.78%)67/78 (85.9%)0.209
  Genotype (B/C)22:1027:120.965
  Biopsy
    G*3 (2 - 3)3 (2 - 3)0.446
    S*3 (2 - 3)3 (2 - 3)0.887
  Duration of pretreatment (days)*13 (7 - 17)4 (2 - 8)< 0.001
  ALT (IU/L)*
    Highest703 (506 - 1,028)757 (542 - 1,185)0.348
    Begin pegIFN311 (280 - 357)
  TBIL(μmol/L)
    Highest17.62 ± 5.4419.10 ± 5.920.154
    Begin pegIFN13.82 ± 4.5615.35 ± 5.680.110
  PT(s)*11.80 (11.40 - 12.50)11.70 (11.40 - 12.43)0.685
  HBV DNA (log10 IU/mL)6.87 ± 1.116.70 ± 0.990.368
  HBsAg (log IU/mL)4.20 ± 0.594.18 ± 0.700.896
  HBeAg (s/co)*740.50 (122.13 - 1,232.29)712.14 (126.79 - 1,071.35)0.404
Results
  ALT normalization, n/total (%)
    Week 1219/63 (30.16%)44/78 (56.41%)0.002
    Week 2425/63 (39.68%)60/78 (76.92%)0.000
    Week 3634/63 (53.97%)69/78 (88.46%)0.004
    Week 4839/63 (61.90%)69/78 (88.46%)< 0.001
    Week 7245/63 (71.43%)69/78 (88.46%)0.011
    Week 9644/63 (69.84%)68/78 (87.18%)0.011
  HBV DNA negative, n/total (%)
    Week 1214/63 (22.22%)26/78 (33.33%)0.146
    Week 2427/63 (42.86%)47/78 (60.26%)0.040
    Week 3636/63 (57.14%)55/78 (70.51%)0.099
    Week 4838/63 (60.32%)70/78 (89.74%)< 0.001
    Week 7236/63 (57.14%)71/78 (91.03%)< 0.001
    Week 9637/63 (58.73%)71/78 (91.03%)< 0.001
  HBeAg seroconversion, n/total (%)
    Week 126/63 (9.52%)6/78 (7.69%)0.698
    Week 248/63 (12.70%)14/78 (17.95%)0.393
    Week 3610/63 (15.87%)16/78 (20.51%)0.480
    Week 4826/63 (41.27%)24/78 (30.77%)0.195
    Week 7229/63 (46.03%)27/78 (34.62%)0.168
    Week 9630/63 (47.62%)30/78 (38.46%)0.274
  HBsAg loss, n/total (%)
    Week 120/63 (0.00%)0/78 (0.00%)
    Week 240/63 (0.00%)1/78 (1.28%)1.000
    Week 361/63 (1.59%)1/78 (1.28%)1.000
    Week 485/63 (7.94%)1/78 (1.28%)0.089
    Week 727/63 (11.11%)1/78 (1.28%)0.022
    Week 969/63 (14.29%)1/78 (1.28%)0.005
  HBsAg seroconversion, n/total (%)
    Week 120/63 (0.00%)None
    Week 240/63 (0.00%)
    Week 361/63 (1.59%)0.447
    Week 482/63 (3.17%)0.198
    Week 723/63 (4.76%)0.087
    Week 963/63 (4.76%)0.087

 

Table 4. The Baseline Characteristics and Outcomes of Acute Exacerbation Patients With ETV or LDT Treatment
 
ETV (n = 38)LDT (n = 40)P value
HBsAg: hepatitis B surface antigen; HBeAg: hepatitis B envelope antigen; ALT: alanine aminotransferase. *Expressed as median (interquartile range).
Baseline
  Age (years)*35 (20 - 39)27 (24 - 32)< 0.001
  Male sex, n (%)32/38 (84.21%)35/40 (87.50%)0.677
  Genotype (B/C)15:0712:050.872
  Biopsy
    G*3 (2 - 3)3 (2 - 3)0.719
    S*3 (2 - 3)3 (2 - 3)0.509
  Duration of pretreatment (days)*5 (2 - 8)4 (2 - 7)0.360
  ALT (IU/L)*
    Highest756 (555 - 1,248)757 (531 - 1,021)0.803
  TBIL (μmol/L)
    Highest19.07 ± 6.1319.12 ± 5.800.972
  PT(s)*11.90 (11.50 - 12.50)11.60 (11.30 - 12.38)0.278
  HBV DNA (log10 IU/mL)6.54 ± 0.986.85 ± 0.990.168
  HBsAg (log IU/mL)4.11 ± 0.664.25 ± 0.750.454
  HBeAg (s/co)537.49 (116.81 - 1,071.12)741.59 (184.91 - 1,102.27)0.470
Results
  ALT normalization, n/total (%)
    Week 1219/38 (50.00%)25/40 (62.50%)0.266
    Week 2424/38 (63.16%)36/40 (90.00%)0.005
    Week 3625/38 (65.79%)35/40 (87.50%)0.023
    Week 4833/38 (86.84%)36/40 (90.00%)0.734
    Week 7233/38 (86.84(%)36/40 (90.00%)0.734
    Week 9632/38 (84.21%)36/40 (90.00%)0.670
  HBV DNA negative, n/total (%)
    Week 1216/38 (42.11%)10/40 (25.00%)0.109
    Week 2424/38 (63.16%)23/40 (57.50%)0.610
    Week 3627/38 (71.05%)28/40 (70.00%)0.919
    Week 4837/38 (97.37%)33/40 (82.50%)0.057
    Week 7236/38 (94.74%)35/40 (87.50%)0.432
    Week 9636/38 (94.74%)35/40 (87.50%)
  HBeAg seroconversion, n/total (%)
    Week 123/38 (7.89%)3/40 (7.50%)1.000
    Week 247/38 (1.84%)7/40 (1.75%)0.916
    Week 367/38 (1.84%)9/40 (22.50%)0.656
    Week 4810/38 (26.32%)14/40 (35.00%)0.406
    Week 7213/38 (34.21%)14/40 (35.00%)0.942
    Week 9614/38 (36.84%)16/40 (40.00%)0.774
  HBsAg loss, n/total (%)
    Week 120/38 (0.00%)0/40 (0.00%)
    Week 241/38 (2.63%)0/40 (0.00%)0.487
    Week 361/38 (2.63%)0/40 (0.00%)0.487
    Week 481/38 (2.63%)0/40 (0.00%)0.487
    Week 721/38 (2.63%)0/40 (0.00%)0.487
    Week 961/38 (2.63%)0/40 (0.00%)0.487
  HBsAg seroconversion, n/total (%)
    Week 12NoneNone
    Week 24
    Week 36
    Week 48
    Week 72
    Week 96