caa a22 4500 445796278 CHVBK 20180317145126.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1007/s10620-011-1597-y doi (NATIONALLICENCE)springer-10.1007/s10620-011-1597-y Defining Virologic Relapse in Chronic Hepatitis B [Elektronische Daten] [Kyung Kim, Dong Sinn, Won Yun, Hyun Cho, Yun Lee, Geum-Youn Gwak, Moon Choi, Joon Lee, Kwang Koh, Byung Yoo, Seung Paik] Background and Aims: Different definitions of virologic relapse (VR) are being used. One way of defining VR is "reappearance of HBV DNA in the serum,” while another definition is an "increase in HBV DNA level greater than 1 log in two determinations at least 4 weeks apart.” The aim of this study was to see the effectiveness of these two definitions Methods: Forty-five HBeAg-positive chronic hepatitis B patients with a virologic response [negative PCR (<12IU/ml)] who had discontinued therapy were analyzed retrospectively for VR, HBeAg reversion and biochemical flare. Results: HBV DNA reappeared in the serum (≥12IU/ml) of all 45 patients (100%). An increase in HBV DNA level greater than 1 log in two determinations at least 4weeks apart was identified in 20 of 25 patients (80%). Biochemical flare and HBeAg reversion were observed in 18 (40%) and 14 (31%) patients, respectively. Peak off-therapy HBV DNA level was significantly associated with biochemical flare (r=0.758, P<0.001) and HBeAg reversion (r=0.645, P<0.001). Two patients with high initial off-therapy HBV DNA levels (≥4.0 log10 IU/ml) were reassessed at 4weeks, and both experienced a biochemical flare and HBeAg reversion. Two patients had an increase in HBV DNA level greater than 1 log at a very low level (1 log to 2 or 3 log), but did not experience biochemical flare or HBeAg reversion during follow-up. Conclusions: Reappearance of HBV DNA was universal when sensitive HBV DNA assay was used. Waiting 4weeks to confirm VR may be harmful for patients with a high HBV DNA level, and was ineffective to indicate re-therapy for patients with increase in HBV DNA at a very low level. There is a need for improved and standardized definitions of VR. Springer Science+Business Media, LLC, 2011 Chronic hepatitis B nationallicence Polymerase chain reaction nationallicence Virologic relapse nationallicence Cutoff values nationallicence Biochemical flare nationallicence CHB : Chronic hepatitis B nationallicence NA : Nucleoside/nucleotide analogues nationallicence HBV : Hepatitis B virus nationallicence PCR : Polymerase chain reaction nationallicence ALT : Alanine aminotransferase nationallicence HBeAg : Hepatitis B e-antigen nationallicence VR : Virologic relapse nationallicence Kim Kyung Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710, Seoul, Korea aut Sinn Dong Department of Medicine, Armed Forces Capital Hospital, Seongnam, Korea aut Yun Won Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710, Seoul, Korea aut Cho Hyun Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710, Seoul, Korea aut Lee Yun Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710, Seoul, Korea aut Gwak Geum-Youn Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710, Seoul, Korea aut Choi Moon Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710, Seoul, Korea aut Lee Joon Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710, Seoul, Korea aut Koh Kwang Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710, Seoul, Korea aut Yoo Byung Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710, Seoul, Korea aut Paik Seung Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710, Seoul, Korea aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/8(2011-08-01), 2432-2438 0163-2116 56:8<2432 2011 56 10620 https://doi.org/10.1007/s10620-011-1597-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-011-1597-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kim Kyung Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710, Seoul, Korea aut NATIONALLICENCE 700 1- Sinn Dong Department of Medicine, Armed Forces Capital Hospital, Seongnam, Korea aut NATIONALLICENCE 700 1- Yun Won Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710, Seoul, Korea aut NATIONALLICENCE 700 1- Cho Hyun Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710, Seoul, Korea aut NATIONALLICENCE 700 1- Lee Yun Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710, Seoul, Korea aut NATIONALLICENCE 700 1- Gwak Geum-Youn Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710, Seoul, Korea aut NATIONALLICENCE 700 1- Choi Moon Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710, Seoul, Korea aut NATIONALLICENCE 700 1- Lee Joon Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710, Seoul, Korea aut NATIONALLICENCE 700 1- Koh Kwang Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710, Seoul, Korea aut NATIONALLICENCE 700 1- Yoo Byung Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710, Seoul, Korea aut NATIONALLICENCE 700 1- Paik Seung Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710, Seoul, Korea aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/8(2011-08-01), 2432-2438 0163-2116 56:8<2432 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer