- Email: [email protected]
P1094 FIBROSIS REGRESSION IN PERSONS TREATED FOR HBV UTILIZING TRANSIENT ELASTOGRAPHY (FIBROSCAN)
POSTERS 23.3%; p 0.017). 3 patients on ST had HBsAg loss compared with MT (1) by 52 weeks. Factors associated with HBsAg loss included ST, higher baseline ALT and female sex. No major therapeutic adverse effects requiring treatment discontinuation. Conclusions: Sequential therapy using tenofovir and PEG-IFN a2b may provide rapid and higher biochemical and virological response in selected HBeAg(+) CHB patients. Long-term clinical trials are needed to assess for sustained durable response. P1093 CXCL-8 PREDICTS HBeAg SEROCONVERSION AND POST TREATMENT FLARES IN CHRONIC HEPATITIS B (CHB) PATIENTS TREATED WITH INTERFERON (IFN)-ALFA S. Le1 , D. Ratnam1 , A. Dev1 , N. Skinner2 , R. Millen2 , P. O’Neill1 , W. Sievert1 , K. Visvanathan2 . 1 Gastroenterology and Hepatology, Monash Health, Monash University, 2 Immunology Research Centre, St Vincent’s Hospital, Melbourne, VIC, Australia E-mail: [email protected] Background and Aims: CXCL-8 is a pro-inflammatory chemokine that induces neutrophil chemotaxis. Low serum CXCL-8 levels correlate with virological response to IFNalfa in HCV patients. We examined the correlation of CXCL-8 and other markers with HBeAg seroconversion and ALT flares in CHB patients treated with IFNalfa. Methods: Treatment naïve CHB patients received either Peg-IFN alone or Peg-IFN and Tenofovir for 48 weeks. Plasma was collected prior to, during and post treatment. CXCL-8, CXCL-10, MCP-1, MIG and IP-10 were measured with cytometric bead array. HBV load, quantitative HBeAg and HBsAg were measured at 9 time points. Results: 17 HBeAg positive patients were recruited and 119 longitudinal plasma specimens collected. Serial ALT levels correlated with IL-10 (Spearman’s rank correlation coefficient (rho) = 0.399, p < 0.001), MIG (rho = 0.492, p < 0.001) and IP-10 (rho = 0.534, p < 0.001). HBeAg seroconversion occurred in 31.3% of patients (no difference between treatment groups). Serum CXCL-8 >10,000 fg/ml at baseline predicted failure to achieve HBeAg seroconversion (PPV: 100%, NPV: 45%). 50% experienced a post-treatment ALT flare (median 87 days, IQR: 64–150 days post treatment). CXCL-8 >10,000 fg/ml one week post IFNalfa completion predicted a HBV flare within 6 months (PPV: 83%, NPV: 60%). Among patients who flared, an increase in CXCL-8 was detected 4–12 weeks before an ALT rise. Other markers rose in tandem with ALT but did not herald the occurrence of flares. Conclusions: CXCL-8 is a potential biomarker for predicting pre and post treatment response to IFNalfa therapy in CHB. CXCL-8 may affect the virological response to IFN-alfa therapy and requires further investigation.
between the initial and follow-up Fibroscan results with clinical significant change considered ≥ 2.0 kPa. Results: 102 (66%) of 154 patients (Mean Age = 49; 60.4% Males) were on HBV treatment, divided in to high potency (entecavir or tenofovir) (n = 55) or low potency (lamivudine) (n = 47) agents. Individuals on therapy showed a significant improvement in average Fibroscan of −1.49 kPa (SD = 4.85) compared to individuals not on treatment changing −0.11 kPa (SD = 2.185) (p = 0.0341). 30.2% of the individuals of the treatment group showed ≥ 2.0 kPa improvement, whereas only 20.0% of the untreated group showed a similar change. Fibrosis change was analyzed by treatment type: 34.4% of the highpotency group, 25.6% of the low-potency group, and 8.4% of the no treatment group showed improvements in Fibroscan readings over 12 months. Conclusions: Therapy of persons with HBV results in improvement of fibrosis level even in short-term follow-up, and can be effectively evaluated by non-invasive methods including Fibroscan. P1095 HBV RNA IN SERUM IS A PREDICTOR OF HBeAg SEROCONVERSION IN PATIENTS WITH CHRONIC HEPATITIS B RECEIVING TREATMENT WITH PEG-INTERFERON ALPHA-2a (40KD) 1 2 F. van Bommel ¨ , A. van Bommel ¨ , H. He3 , C. Wat3 , D. Deichsel1 , 1 1 T. Berg1 , S. Bohm ¨ . Gastroenterologie und Rheumatologie, University of Leipzig, Leipzig, 2 Max Planck Institute for Molecular Genetics, Berlin, Germany; 3 Roche Products Ltd., Welwyn, United Kingdom E-mail: fl[email protected]
Background and Aims: We explored HBV RNA as a predictor of HBeAg seroconversion in patients with chronic hepatitis B (CHB). Methods: 16 pairs of patients with HBeAg positive CHB (HBeAg seroconversion vs. non-seroconversion, matched by country and genotype) treated with Peg-IFN alpha-2a for 48 weeks and observed for additional 24 weeks were retrospectively studied. HBV RNA was quantified from serum samples collected at baseline, at weeks 12 and 24 of treatment. The factors HBV RNA, HBV DNA, HBsAg and ALT levels at baseline, week 12 and 24 were explored for their association with HBeAg seroconversion.
P1094 FIBROSIS REGRESSION IN PERSONS TREATED FOR HBV UTILIZING TRANSIENT ELASTOGRAPHY (FIBROSCAN) A. Ramji, A. Round, O. Takach, E. Lam, H.H. Ko. University of British Columbia, Vancouver, BC, Canada E-mail: [email protected] Background and Aims: Chronic hepatitis B (HBV) may result in significant fibrosis with time and requires continuous evaluation. Transient elastography (Fibroscan) is the preferred non-invasive modality. We sought to evaluate if therapy for HBV results in changes in fibrosis level utilizing Fibroscan technology, and to report if fibrosis regression is affected by the choice of therapeutic agent. Methods: Retrospective analysis of patients with chronic hepatitis B undergoing follow-up Fibroscans (12 months apart) at a tertiary care center over a 36-month period. A Mann Whitney U test determined whether there was any statistical significant difference S442
Figure: Receiver operating characteristic (ROC) curves for the prediction of HBeAg seroconversion by levels of HBV DNA, HBsAg and HBV RNA at week 24 of treatment with Peg-IFN alpha-2a.
Journal of Hepatology 2014 vol. 60 | S361–S522
between the initial and follow-up Fibroscan results with clinical significant change considered ≥ 2.0 kPa. Results: 102 (66%) of 154 patients (Mean Age = 49; 60.4% Males) were on HBV treatment, divided in to high potency (entecavir or tenofovir) (n = 55) or low potency (lamivudine) (n = 47) agents. Individuals on therapy showed a significant improvement in average Fibroscan of −1.49 kPa (SD = 4.85) compared to individuals not on treatment changing −0.11 kPa (SD = 2.185) (p = 0.0341). 30.2% of the individuals of the treatment group showed ≥ 2.0 kPa improvement, whereas only 20.0% of the untreated group showed a similar change. Fibrosis change was analyzed by treatment type: 34.4% of the highpotency group, 25.6% of the low-potency group, and 8.4% of the no treatment group showed improvements in Fibroscan readings over 12 months. Conclusions: Therapy of persons with HBV results in improvement of fibrosis level even in short-term follow-up, and can be effectively evaluated by non-invasive methods including Fibroscan. P1095 HBV RNA IN SERUM IS A PREDICTOR OF HBeAg SEROCONVERSION IN PATIENTS WITH CHRONIC HEPATITIS B RECEIVING TREATMENT WITH PEG-INTERFERON ALPHA-2a (40KD) 1 2 F. van Bommel ¨ , A. van Bommel ¨ , H. He3 , C. Wat3 , D. Deichsel1 , 1 1 T. Berg1 , S. Bohm ¨ . Gastroenterologie und Rheumatologie, University of Leipzig, Leipzig, 2 Max Planck Institute for Molecular Genetics, Berlin, Germany; 3 Roche Products Ltd., Welwyn, United Kingdom E-mail: fl[email protected]
Background and Aims: We explored HBV RNA as a predictor of HBeAg seroconversion in patients with chronic hepatitis B (CHB). Methods: 16 pairs of patients with HBeAg positive CHB (HBeAg seroconversion vs. non-seroconversion, matched by country and genotype) treated with Peg-IFN alpha-2a for 48 weeks and observed for additional 24 weeks were retrospectively studied. HBV RNA was quantified from serum samples collected at baseline, at weeks 12 and 24 of treatment. The factors HBV RNA, HBV DNA, HBsAg and ALT levels at baseline, week 12 and 24 were explored for their association with HBeAg seroconversion.
P1094 FIBROSIS REGRESSION IN PERSONS TREATED FOR HBV UTILIZING TRANSIENT ELASTOGRAPHY (FIBROSCAN) A. Ramji, A. Round, O. Takach, E. Lam, H.H. Ko. University of British Columbia, Vancouver, BC, Canada E-mail: [email protected] Background and Aims: Chronic hepatitis B (HBV) may result in significant fibrosis with time and requires continuous evaluation. Transient elastography (Fibroscan) is the preferred non-invasive modality. We sought to evaluate if therapy for HBV results in changes in fibrosis level utilizing Fibroscan technology, and to report if fibrosis regression is affected by the choice of therapeutic agent. Methods: Retrospective analysis of patients with chronic hepatitis B undergoing follow-up Fibroscans (12 months apart) at a tertiary care center over a 36-month period. A Mann Whitney U test determined whether there was any statistical significant difference S442
Figure: Receiver operating characteristic (ROC) curves for the prediction of HBeAg seroconversion by levels of HBV DNA, HBsAg and HBV RNA at week 24 of treatment with Peg-IFN alpha-2a.
Journal of Hepatology 2014 vol. 60 | S361–S522