Nucleoside/Nucleotide Analogues for the Treatment of Chronic Hepatitis B: A 3-Year Follow Up Study

Introduction. Chronic hepatitis B (CHB) is endemic in Indonesia, where it is usually treated with pegylated interferon and nucleoside/nucleotide analogs (NA). The aim of this study was to determine the efficacy of treating CHB infection among Indonesian patients with NA (lamivudine, telbivudine, and...

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Autores principales:	Andri Sanityoso Sulaiman, Irsan Hasan, Cosmas Rinaldi A. Lesmana, Chyntia Olivia M. Jasirwan, Saut Horas H. Nababan, Kemal Fariz Kalista, Gita Aprilicia, Rino Alvani Gani
Formato:	article
Lenguaje:	ID
Publicado:	Department of Internal Medicine, Faculty of Medicine Universitas Indonesia-Cipto Mangunkusumo Hospital 2021
Materias:	3-years follow up study chronic hepatitis b nucleoside/nucleotide analogue Internal medicine RC31-1245
Acceso en línea:	http://dx.doi.org/10.7454/jpdi.v8i3.598 https://doaj.org/article/b9a3008287954cbd80b50243ff002e2b
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spelling	oai:doaj.org-article:b9a3008287954cbd80b50243ff002e2b2021-11-17T14:03:42ZNucleoside/Nucleotide Analogues for the Treatment of Chronic Hepatitis B: A 3-Year Follow Up Studyhttp://dx.doi.org/10.7454/jpdi.v8i3.5982406-89692549-0621https://doaj.org/article/b9a3008287954cbd80b50243ff002e2b2021-08-01T00:00:00Zhttp://jurnalpenyakitdalam.ui.ac.id/index.php/jpdi/article/view/598/284https://doaj.org/toc/2406-8969https://doaj.org/toc/2549-0621Introduction. Chronic hepatitis B (CHB) is endemic in Indonesia, where it is usually treated with pegylated interferon and nucleoside/nucleotide analogs (NA). The aim of this study was to determine the efficacy of treating CHB infection among Indonesian patients with NA (lamivudine, telbivudine, and tenofovir) for a 3-year period. Methods. We retrospectively reviewed the records of patients with CHB infection attending the Hepatology Clinic Cipto Mangunkusumo during 2010-2013 period. Subjects with inclusion criteria were all patients aged above 18 years treated with NA for at least three years. The degree of liver stiffness, hepatitis B virus deoxyribonucleic acid (HBV-DNA), alanine aminotransferase (ALT) levels, and hepatitis B antigen (HBeAg) were assessed before and after 3-years therapy. Results. A total of 62 subjects were included in the study. Forty-eight patients (77%) were treated with telbivudine, 9 (15%) with tenofovir, and 5 (8%) with lamivudine. At baseline prior to the onset of therapy, 52 patients (84%) had a positive HBeAg test, 15 patients (24%) had F3 liver disease (advance fibrosis), and 36 (58%) had liver cirrhosis using transient elastography. At the end of the 3 year study period, median of liver stiffness significantly decline from baseline (14.5 (3.3 – 59.3) kPa to 6.7 (3.3 – 37.2) kPa, p = 0.001), HBV DNA load significantly decline (1.31 x 107 (2.0x106 – 1.0x108) copies/mL to 0 (0 – 1.7 x 107) copies/mL, p = 0.001), alanine aminotransferase (ALT) levels significantly decline (58 (11– 404) U/L to 27 (8-291) U/L, p = 0.001). Nevertheless, there were five patients (8%) who still had F3 liver disease, and 20 patients (32.3%) had F4 liver disease, 21 (34%) had detectable HBV-DNA, 17 (27%) had not achieved ALT normalization. From 52 patients with positive HBeAg baseline, there were 20 patients (39%) who had seroconversion to negative HBeAg after three year period. Conclusion. NA therapy resulted in a reduction level of fibrosis in CHB induced liver disease.Andri Sanityoso SulaimanIrsan HasanCosmas Rinaldi A. LesmanaChyntia Olivia M. JasirwanSaut Horas H. NababanKemal Fariz KalistaGita ApriliciaRino Alvani GaniDepartment of Internal Medicine, Faculty of Medicine Universitas Indonesia-Cipto Mangunkusumo Hospitalarticle3-years follow up studychronic hepatitis bnucleoside/nucleotide analogueInternal medicineRC31-1245IDJurnal Penyakit Dalam Indonesia, Vol 8, Iss 3, Pp 139-145 (2021)
institution	DOAJ
collection	DOAJ
language	ID
topic	3-years follow up study chronic hepatitis b nucleoside/nucleotide analogue Internal medicine RC31-1245
spellingShingle	3-years follow up study chronic hepatitis b nucleoside/nucleotide analogue Internal medicine RC31-1245 Andri Sanityoso Sulaiman Irsan Hasan Cosmas Rinaldi A. Lesmana Chyntia Olivia M. Jasirwan Saut Horas H. Nababan Kemal Fariz Kalista Gita Aprilicia Rino Alvani Gani Nucleoside/Nucleotide Analogues for the Treatment of Chronic Hepatitis B: A 3-Year Follow Up Study
description	Introduction. Chronic hepatitis B (CHB) is endemic in Indonesia, where it is usually treated with pegylated interferon and nucleoside/nucleotide analogs (NA). The aim of this study was to determine the efficacy of treating CHB infection among Indonesian patients with NA (lamivudine, telbivudine, and tenofovir) for a 3-year period. Methods. We retrospectively reviewed the records of patients with CHB infection attending the Hepatology Clinic Cipto Mangunkusumo during 2010-2013 period. Subjects with inclusion criteria were all patients aged above 18 years treated with NA for at least three years. The degree of liver stiffness, hepatitis B virus deoxyribonucleic acid (HBV-DNA), alanine aminotransferase (ALT) levels, and hepatitis B antigen (HBeAg) were assessed before and after 3-years therapy. Results. A total of 62 subjects were included in the study. Forty-eight patients (77%) were treated with telbivudine, 9 (15%) with tenofovir, and 5 (8%) with lamivudine. At baseline prior to the onset of therapy, 52 patients (84%) had a positive HBeAg test, 15 patients (24%) had F3 liver disease (advance fibrosis), and 36 (58%) had liver cirrhosis using transient elastography. At the end of the 3 year study period, median of liver stiffness significantly decline from baseline (14.5 (3.3 – 59.3) kPa to 6.7 (3.3 – 37.2) kPa, p = 0.001), HBV DNA load significantly decline (1.31 x 107 (2.0x106 – 1.0x108) copies/mL to 0 (0 – 1.7 x 107) copies/mL, p = 0.001), alanine aminotransferase (ALT) levels significantly decline (58 (11– 404) U/L to 27 (8-291) U/L, p = 0.001). Nevertheless, there were five patients (8%) who still had F3 liver disease, and 20 patients (32.3%) had F4 liver disease, 21 (34%) had detectable HBV-DNA, 17 (27%) had not achieved ALT normalization. From 52 patients with positive HBeAg baseline, there were 20 patients (39%) who had seroconversion to negative HBeAg after three year period. Conclusion. NA therapy resulted in a reduction level of fibrosis in CHB induced liver disease.
format	article
author	Andri Sanityoso Sulaiman Irsan Hasan Cosmas Rinaldi A. Lesmana Chyntia Olivia M. Jasirwan Saut Horas H. Nababan Kemal Fariz Kalista Gita Aprilicia Rino Alvani Gani
author_facet	Andri Sanityoso Sulaiman Irsan Hasan Cosmas Rinaldi A. Lesmana Chyntia Olivia M. Jasirwan Saut Horas H. Nababan Kemal Fariz Kalista Gita Aprilicia Rino Alvani Gani
author_sort	Andri Sanityoso Sulaiman
title	Nucleoside/Nucleotide Analogues for the Treatment of Chronic Hepatitis B: A 3-Year Follow Up Study
title_short	Nucleoside/Nucleotide Analogues for the Treatment of Chronic Hepatitis B: A 3-Year Follow Up Study
title_full	Nucleoside/Nucleotide Analogues for the Treatment of Chronic Hepatitis B: A 3-Year Follow Up Study
title_fullStr	Nucleoside/Nucleotide Analogues for the Treatment of Chronic Hepatitis B: A 3-Year Follow Up Study
title_full_unstemmed	Nucleoside/Nucleotide Analogues for the Treatment of Chronic Hepatitis B: A 3-Year Follow Up Study
title_sort	nucleoside/nucleotide analogues for the treatment of chronic hepatitis b: a 3-year follow up study
publisher	Department of Internal Medicine, Faculty of Medicine Universitas Indonesia-Cipto Mangunkusumo Hospital
publishDate	2021
url	http://dx.doi.org/10.7454/jpdi.v8i3.598 https://doaj.org/article/b9a3008287954cbd80b50243ff002e2b
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Nucleoside/Nucleotide Analogues for the Treatment of Chronic Hepatitis B: A 3-Year Follow Up Study

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