protein 10 (IP10) serum levels predict the decline of HBsAg

[stef2011]

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ABSTRACT FINAL ID: 1890
ABSTRACT TITLE: Interferon-inducible protein 10 (IP10) serum levels predict the decline of HBsAg serum levels in HBeAg-negative chronic hepatitis B (CHBe-) patients treated with tenofovir disoproxil fumarate (TDF)
PRESENTER: George Papatheodoridis
ABSTRACT BODY:
Background/Aim: Serum HBsAg levels are considered as a potential predictor of on-therapy and most importantly off-therapy remission in CHBe- patients treated with nucleos(t)ide analogue(s) (NA). We recently reported that serum IP10 levels represent a promising predictor of HBsAg decline in CHBe- patients treated with entecavir. We studied the changes and predictors of decline of HBsAg levels in patients with compensated CHBe- treated with TDF for ≥12 months. Methods: 160 patients (M/F:117/43, mean age:56±16 years) who started TDF therapy between 2008-2012 were enrolled: 82 were NA naive (Group A) and 78 had been exposed to other NA (lamivudine resistance: 68, telbivudine resistance: 6, other: 4) (Group B). TDF has been given for a mean of 35±18 months as monotherapy in all but 55 patients of group B who received TDF and lamivudine/telbivudine for the first 6-12 months. Stored serum samples taken before and at 6, 12, 24, 36 and 48 months after TDF onset were tested for HBsAg levels on the Architect analyzer (Abbott). In 78 patients, stored serum samples before TDF onset were tested for IP10 levels by a solid phase sandwich ELISA (BioVendor). Results: Before TDF onset, Group A and B patients had median serum levels of ALT 78 and 36 IU/L (p<0.001), HBV DNA 5.8 and 3.4 log10 IU/mL (p<0.001) and HBsAg 3.5 and 3.2 log10 IU/mL (p=0.330), respectively. Virological remission (undetectable HBV DNA) rates were 92% at 12 months and 99% beyond 12 months, without difference between Group A and B. Compared to before TDF, HBsAg levels decreased by a median of 0.17, 032, 0.42 and 0.48 log10 IU/mL at 12, 24, 36 and 48 months, respectively (p0.5 log10 was significantly associated only with higher IP10 levels (p=0.005) and particularly with IP10 >350 pg/mL (RH:5.58, 95% CI: 1.87-16.65, p=0.002). Conclusions: In both NA naive and experienced patients with CHBe-, TDF therapy decreases serum HBsAg levels. After 4 years of therapy, HBsAg levels ≤100 or ≤1000 IU/mL can be achieved in approximately 30% and 50% of patients, particularly those with low baseline HBsAg levels. HBsAg decline is slow (>0.5 log10 in 36% of patients after 4 years) and is associated only with higher baseline serum IP10 levels.

[stef2011]

on high hbsag levels: the longer on tdf the better, some trial had response after 3 years on tdf despite hbsag levels others after 5 years

when hbsag<1000iu/ml response was found on 100% patients and hbsag loss on 91%.patients were on antivirals many years

[melcul]

sequential means to take meds for a period of years, nothing that you asked there .

[mer971]

Stef, let me be clear one more time. Sequential, it means after 4 years or when hbsag is(less 1000) you add peg inter, but meantime tnf you don't have to interrupt? am I right?, and one more question; how long did you use Gcmaf? thanks

[melcul]

i understand the peg must be used after a few years of sequential, this in case you are strong enough to not develop any side effects like luckyman here who after not even a year developed both of them , bone density and high creatinine

[stef2011]

you  have to understand what they do, as we said already we already know the sequential that can rescue immune system and make pegintf hbsag clearance, all the rest is toilet paper, end of story

as we are posting from many years now the cure is tenofovir 5-10years and then pegintf add on when hbsag<1000iu/ml with 91% clearance, all the rest is not even useful to post here......do you see me posting about the wrong combination of peg and nucs?anybody by now knows how the combo must be used....

[melcul]

stef, don't you think is weird that so many posts are contradicting each other ? i mean look at luckyman's post about aasld poster, is just totally contradicting the results, i mean ,it's my first time when i have to learn about a disease but it is very confusing and frustrating to hear good news - bad news about the same thing every time

[stef2011]

the only extremely interesting data of this study is:
tdf gets 50% of patients with hbsag less than 1000iu/ml by 4 years

this 50% can cure hbv in 91% cases by pegintf add on and the 9% without hbsag loss achieve extremely low hbsag anyway

[melcul]

nice, thanks for posting this ,

"particularly those with low baseline HBsAg levels. HBsAg decline is slow (>0.5 log10 in 36% of patients after 4 years) and is associated only with higher baseline serum IP10 levels."

so if i have a high hbsag baseline like mine  , 350- 400k ,and also naive i would decline much faster ?

[stef2011]

i dont see hbv cure so far, i still think it is in our hands and proper tests and combos of tdf, vit d3 and pegintf add on can cure most patients by 5-10years

[stef2011]

After 4 years of therapy, HBsAg levels ≤100 or ≤1000 IU/mL can be achieved in approximately 30% and 50% of patients

50% of patients with hbsag less than 1000iu/ml by 4 years

not bad at all if you consider pegintf add on can cure 91% of them and maybe adding vit d3 or dr coimbra protocol of vit d3 may take this 50% even higher