Baseline Hepatitis B Virus DNA Level is a Promising Factor for Predicting the 3^rd Month Virological Response to Entecavir Therapy： A Study of Strict Defined Hepatitis B virus Induced Cirrhosis
Baseline Hepatitis B Virus DNA Level is a Promising Factor for Predicting the 3^rd Month Virological Response to Entecavir Therapy： A Study of Strict Defined Hepatitis B virus Induced Cirrhosis作者机构：Department of Liver Research Center Beijing Friendship Hospital Capital Medical University Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis and National Clinical Research Center of Digestive Diseases Beijing 100050 China Clinical Epidemiology and Evidence-based Medicine Center Beijing Friendship Hospital Capital Medical University Beijing 100050 China
出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)
年 卷 期：2015年第128卷第14期
页 面：1867-1872页
核心收录：
学科分类：090603[农学-临床兽医学] 0710[理学-生物学] 07[理学] 08[工学] 09[农学] 0906[农学-兽医学] 071007[理学-遗传学] 0901[农学-作物学] 0836[工学-生物工程] 090102[农学-作物遗传育种]
基 金：supported by grants from the Key Project from Beijing Municipal Science and Technology Commission Program of National Science and Technology Major Project Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support
主 题：Area Under Receiver Operating Characteristic Curve Baseline Parameters Cirrhosis Entecavir Hepatitis B viral
摘 要：Background： Cirrhosis is a common complication of chronic hepatitis B. It remains unclear if viral and biochemical parameters at baseline affect virological response to entecavir and therefore warrant investigation. In the present study, we aimed to eval uate the efficacy of entecavir therapy by monitoring virological response at the end of the 3^rd month of treatment and try to figure out whether baseline factors could help predict it in a cohort of hepatitis B virus （HBV） compensated cirrhosis patients and to determine the cut-off value of a predicting parameter. Methods： A total of 91 nucleos（t）ide-naive patients with HBV induced cirrhosis （compensatory stage） were enrolled in a prospective cohort. HBV DNA and alanine aminotransferase （ALT） were tested at baseline and monitored every 3-6 months after starting therapy. Results： Of all 91 patients, the median follow-up time was 12 （9-24） months. Overall, 64 patients （70.3%） achieved virological response in the 3^rd month. Univariate analysis showed that the 3^rd month virological response can be predicted by baseline HBV DNA levels （P 〈 0.001, odds ratio [OR]： 2.13, 95% confidence interval [CI]： 1.44-3.15）, ALT value （P = 0.023, OR： 1.01, 95% CI： 1.00 1.01 ） and hepatitis B e antigen （HBeAg） negativity （P = 0.016, OR： 0.30, 95% CI： 0.11-0.80）. Multiple regression analysis showed baseline H BV DNA level was the only parameter related to full virological response. Higher baseline HBV DNA strata indicated a higher probability that HBV DNA remains detectable at the 3^rd month （P = 0.001）. Area under receiver operating characteristic curve for determining the 3^rd month virological response by baseline HBV DNA was 77.6% （95% CI： 66.7-85.2%）, with a best cut-offvalue of 5.8 log10. Conclusions： Baseline HBV DNA, HBeAg negativity, and ALT were independent factors contributing to virological response at the 3^rt month. Further, multiple regression showed that HBV DNA level was the only parameter predicting full virolog
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