What Is the Best End Point for Hepatitis B Treatment?
Authors: Ching-Lung Lai, Man-Fung Yuen
Journal: Annals of Internal Medicine (2008)

Letters1 April 2008What Is the Best End Point for Hepatitis B Treatment?Ching-Lung Lai, MD and Man-Fung Yuen, MD, PhDChing-Lung Lai, MDFrom the University of Hong Kong, Queen Mary Hospital, Hong Kong, China.Search for more papers by this author and Man-Fung Yuen, MD, PhDFrom the University of Hong Kong, Queen Mary Hospital, Hong Kong, China.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-148-7-200804010-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We write in response to the editorial by Degertekin and Lok (1), which addressed our article on standard treatment criteria and end points for hepatitis B (2). Degertekin and Lok state that “[a]lthough HBV [hepatitis B virus] replication after HBeAg [hepatitis B e antigen] seroconversion can be reactivated … an occurrence of 30% over 10 years does not justify continuing treatment for all patients” (1). A 30% occurrence rate is very high. The risk for myocardial infarction with hypercholesterolemia in a placebo-controlled trial is 7.9% at 5 years (3); no physician would consider stopping the treatment of ...References1. Degertekin B, Lok AS. When to start and stop hepatitis B treatment: can one set of criteria apply to all patients regardless of age at infection? [Editorial]. Ann Intern Med. 2007;147:62-4. [PMID: 17606963] LinkGoogle Scholar2. Lai CL, Yuen MF. The natural history and treatment of chronic hepatitis B: a critical evaluation of standard treatment criteria and end points. Ann Intern Med. 2007;147:58-61. [PMID: 17606962] LinkGoogle Scholar3. Shepherd J, Cobbe SM, Ford I, Isles CG, Lorimer AR, MacFarlane PW, et al. Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. West of Scotland Coronary Prevention Study Group. N Engl J Med. 1995;333:1301-7. [PMID: 7566020] CrossrefMedlineGoogle Scholar4. Chen CJ, Yang HI, Su J, Jen CL, You SL, Lu SN, et al; REVEAL-HBV Study Group. Risk of hepatocellular carcinoma across a biological gradient of serum hepatitis B virus DNA level. JAMA. 2006;295:65-73. [PMID: 16391218] CrossrefMedlineGoogle Scholar5. Zacharakis G, Koskinas J, Kotsiou S, Pouliou E, Papoutselis M, Tzara F, et al. Natural history of chronic hepatitis B virus infection in children of different ethnic origins: a cohort study with up to 12 years' follow-up in northern Greece. J Pediatr Gastroenterol Nutr. 2007;44:84-91. [PMID: 17204959] CrossrefMedlineGoogle Scholar6. Lok AS, McMahon BJ; Practice Guidelines Committee. American Association for the Study of Liver Diseases (AASLD). Chronic hepatitis B: update of recommendations. Hepatology. 2004;39:857-61. [PMID: 14999707] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From the University of Hong Kong, Queen Mary Hospital, Hong Kong, China.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Natural History and Treatment of Chronic Hepatitis B: A Critical Evaluation of Standard Treatment Criteria and End Points Ching-Lung Lai and Man-Fung Yuen What Is the Best End Point for Hepatitis B Treatment? Bulent Degertekin and Anna S.F. Lok Metrics Cited bySystemic corticosteroid and reactivation of chronic hepatitis B 1 April 2008Volume 148, Issue 7Page: 560KeywordsAlanine aminotransferaseCirrhosisDNAHepatitis BHepatitis DHepatocellular carcinomaPediatric infectionsPolymerase chain reactionPopulation statisticsViral replication ePublished: 1 April 2008 Issue Published: 1 April 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...