Classification of virologic trajectories during nucleos/tide analogue treatment of hepatitis B virus (HBV) infection DOI Creative Commons
Tingyan Wang, Cori Campbell, Alexander Stockdale

и другие.

medRxiv (Cold Spring Harbor Laboratory), Год журнала: 2023, Номер unknown

Опубликована: Дек. 1, 2023

Abstract Background & Aims The dynamics of HBV viral load (VL) in patients with chronic hepatitis B (CHB) on nucleos/tide analogue (NA) treatment and its relationship liver disease are poorly understood. We aimed to study longitudinal VL patterns their associations CHB clinical outcomes. Methods Utilising large scale, routinely collected electronic health records from six centres England, collated by the National Institute for Health Care Research Informatics Collaborative (NIHR HIC), we applied latent class mixed models investigate trajectory adults receiving NA treatment. assessed alanine transaminase (ALT), fibrosis/cirrhosis. Results retrieved data 1885 (median follow-up 6.2 years, interquartile range (IQR) 3.7-9.3 years), 21,691 measurements 10 per patient, IQR 5-17). Five classes were identified derivation cohort (n=1367, discrimination: 0.93, entropy: 0.90): 1 ‘long term suppression’ (n=827, 60.5%), 2 ‘timely virological (n=254, 18.6%), 3 ‘persistent moderate viraemia’ (n=140, 10.2%), 4 high-level (n=44, 3.2%), 5 ‘slow (n=102, 7.5%). model demonstrated a discrimination 0.93 entropy 0.88 validation (n=518). ALT decreased variably over time VL-suppressed groups (classes 1, 2, 5; all p<0.001), but did not significantly improve those persistent viraemia 3, 4). Patients had 2-fold increased hazards fibrosis/cirrhosis compared (adjusted hazard ratio, 2.00; 95% CI, 1.33-3.02). Conclusions Heterogeneity exists response therapy patients, 20% showing potentially suboptimal responses. Slow suppression is associated progression.

Язык: Английский

Distinct virologic trajectories in chronic hepatitis B identify heterogeneity in response to nucleos/tide analogue therapy DOI Creative Commons
Tingyan Wang, Cori Campbell, Alexander Stockdale

и другие.

JHEP Reports, Год журнала: 2024, Номер 7(1), С. 101229 - 101229

Опубликована: Окт. 9, 2024

Highlights•Virologic responses to NA therapy in chronic hepatitis B patients show significant variability.•Five distinct virologic trajectory classes with clinical, laboratory and demographic features are identified.•Over 20% of exhibit suboptimal virological treatment.•Complete suppression for on current standard antiviral treatment can be slow.•Slow is associated a twofold increased risk fibrosis/cirrhosis.AbstractBackground & AimsThe dynamics HBV viral load (VL) (CHB) nucleos/tide analogue (NA) its relationship liver disease poorly understood. We aimed study longitudinal VL patterns their associations CHB clinical outcomes.MethodsUtilising large scale, routinely collected electronic health records from six centres England, collated by the National Institute Health Care Research Informatics Collaborative (NIHR HIC), we applied latent class mixed models investigate adults receiving treatment. assessed alanine transaminase (ALT), fibrosis/cirrhosis.ResultsWe retrieved data 1885 (median follow-up 6.2 years, interquartile range (IQR) 3.7-9.3 years), 21,691 measurements 10 per patient, IQR 5-17). Five were identified derivation cohort (n=1367, discrimination: 0.93, entropy: 0.90): 1 'long term suppression' (n=827, 60.5%), 2 'timely (n=254, 18.6%), 3 'persistent moderate viraemia' (n=140, 10.2%), 4 high-level (n=44, 3.2%), 5 'slow (n=102, 7.5%). The model demonstrated discrimination 0.93 entropy 0.88 validation (n=518). ALT decreased variably over time VL-suppressed groups (classes 1, 2, 5; all p<0.001), but did not significantly improve those persistent viraemia 3, 4). Patients had 2-fold hazards fibrosis/cirrhosis compared (adjusted hazard ratio, 2.00; 95% CI, 1.33-3.02).ConclusionsHeterogeneity exists response patients, showing potentially responses. Slow progression.Graphical abstract

Язык: Английский

Процитировано

3
Classification of virologic trajectories during nucleos/tide analogue treatment of hepatitis B virus (HBV) infection DOI Creative Commons
Tingyan Wang, Cori Campbell, Alexander Stockdale

и другие.

medRxiv (Cold Spring Harbor Laboratory), Год журнала: 2023, Номер unknown

Опубликована: Дек. 1, 2023

Abstract Background & Aims The dynamics of HBV viral load (VL) in patients with chronic hepatitis B (CHB) on nucleos/tide analogue (NA) treatment and its relationship liver disease are poorly understood. We aimed to study longitudinal VL patterns their associations CHB clinical outcomes. Methods Utilising large scale, routinely collected electronic health records from six centres England, collated by the National Institute for Health Care Research Informatics Collaborative (NIHR HIC), we applied latent class mixed models investigate trajectory adults receiving NA treatment. assessed alanine transaminase (ALT), fibrosis/cirrhosis. Results retrieved data 1885 (median follow-up 6.2 years, interquartile range (IQR) 3.7-9.3 years), 21,691 measurements 10 per patient, IQR 5-17). Five classes were identified derivation cohort (n=1367, discrimination: 0.93, entropy: 0.90): 1 ‘long term suppression’ (n=827, 60.5%), 2 ‘timely virological (n=254, 18.6%), 3 ‘persistent moderate viraemia’ (n=140, 10.2%), 4 high-level (n=44, 3.2%), 5 ‘slow (n=102, 7.5%). model demonstrated a discrimination 0.93 entropy 0.88 validation (n=518). ALT decreased variably over time VL-suppressed groups (classes 1, 2, 5; all p<0.001), but did not significantly improve those persistent viraemia 3, 4). Patients had 2-fold increased hazards fibrosis/cirrhosis compared (adjusted hazard ratio, 2.00; 95% CI, 1.33-3.02). Conclusions Heterogeneity exists response therapy patients, 20% showing potentially suboptimal responses. Slow suppression is associated progression.

Язык: Английский

Процитировано

2