BibTex format
@article{Wang:2025:10.1016/j.jhepr.2024.101229,
author = {Wang, T and Campbell, C and Stockdale, AJ and Todd, S and McIntyre, K and Frankland, A and Jaworski, J and Glampson, B and Papadimitriou, D and Mercuri, L and Mayer, E and Jones, CR and Salih, H and Roadknight, G and Little, S and Noble, T and Várnai, KA and Davis, C and Heinson, AI and George, M and Borca, F and English, L and Romão, L and Ramlakhan, D and NIHR, HIC Viral Hepatitis and Liver Disease Consortium and Woods, K and Davies, J and Nastouli, E and Khakoo, SI and Gelson, W and Cooke, GS and Barnes, E and Matthews, PC},
doi = {10.1016/j.jhepr.2024.101229},
journal = {JHEP Rep},
title = {Distinct virologic trajectories in chronic hepatitis B identify heterogeneity in response to nucleos(t)ide analogue therapy.},
url = {http://dx.doi.org/10.1016/j.jhepr.2024.101229},
volume = {7},
year = {2025}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - BACKGROUND & AIMS: The dynamics of HBV viral load (VL) in patients with chronic hepatitis B (CHB) on nucleos(t)ide analogue (NA) treatment and its relationship with liver disease are poorly understood. We aimed to study longitudinal VL patterns and their associations with CHB clinical outcomes. METHODS: Utilising large scale, routinely collected electronic health records from six centres in England, collated by the National Institute for Health and Care Research Health Informatics Collaborative (NIHR HIC), we applied latent class mixed models to investigate VL trajectory patterns in adults receiving NA treatment. We assessed associations of VL trajectory with alanine transaminase, and with liver fibrosis/cirrhosis. RESULTS: We retrieved data from 1,885 adults on NA treatment (median follow-up 6.2 years, IQR 3.7-9.3 years), with 21,691 VL measurements (median 10 per patient, IQR 5-17). Five VL classes were identified from the derivation cohort (n = 1,367, discrimination: 0.93, entropy: 0.90): class 1 'long term suppression' (n = 827, 60.5%), class 2 'timely virological suppression' (n = 254, 18.6%), class 3 'persistent moderate viraemia' (n = 140, 10.2%), class 4 'persistent high-level viraemia' (n = 44, 3.2%), and class 5 'slow virological suppression' (n = 102, 7.5%). The model demonstrated a discrimination of 0.93 and entropy of 0.88 for the validation cohort (n = 518). Alanine transaminase decreased variably over time in VL-suppressed groups (classes 1, 2, 5; all p <0.001), but did not significantly improve in those with persistent viraemia (classes 3, 4). Patients in class 5 had twofold increased hazards of fibrosis/cirrhosis compared with class 1 (adjusted hazard ratio, 2.00; 95% CI, 1.33-3.02). CONCLUSIONS: Heterogeneity exists in virological response to NA therapy in CHB patients, with over 20% showing potentially suboptimal responses. Slow virological suppression is associated with liver disease progression. IMPACT A
AU - Wang,T
AU - Campbell,C
AU - Stockdale,AJ
AU - Todd,S
AU - McIntyre,K
AU - Frankland,A
AU - Jaworski,J
AU - Glampson,B
AU - Papadimitriou,D
AU - Mercuri,L
AU - Mayer,E
AU - Jones,CR
AU - Salih,H
AU - Roadknight,G
AU - Little,S
AU - Noble,T
AU - Várnai,KA
AU - Davis,C
AU - Heinson,AI
AU - George,M
AU - Borca,F
AU - English,L
AU - Romão,L
AU - Ramlakhan,D
AU - NIHR,HIC Viral Hepatitis and Liver Disease Consortium
AU - Woods,K
AU - Davies,J
AU - Nastouli,E
AU - Khakoo,SI
AU - Gelson,W
AU - Cooke,GS
AU - Barnes,E
AU - Matthews,PC
DO - 10.1016/j.jhepr.2024.101229
PY - 2025///
TI - Distinct virologic trajectories in chronic hepatitis B identify heterogeneity in response to nucleos(t)ide analogue therapy.
T2 - JHEP Rep
UR - http://dx.doi.org/10.1016/j.jhepr.2024.101229
UR - https://www.ncbi.nlm.nih.gov/pubmed/39717508
VL - 7
ER -