What Is the Best End Point for Hepatitis B Treatment?
Authors: Bulent Degertekin, Anna S.F. Lok
Journal: Annals of Internal Medicine (2008)

Letters1 April 2008What Is the Best End Point for Hepatitis B Treatment?Bulent Degertekin, MD and Anna S.F. Lok, MDBulent Degertekin, MDFrom the University of Michigan Health System, Ann Arbor, MI 48109.Search for more papers by this author and Anna S.F. Lok, MDFrom the University of Michigan Health System, Ann Arbor, MI 48109.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-148-7-200804010-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate Drs. Lai and Yuen's comments. We agree that lifelong maintenance therapy would be preferred when safe, affordable, and effective treatment is available to prevent disease recurrence. However, the safety of lifetime use of nucleoside or nucleotide analogues for hepatitis B has not been established. Adefovir is associated with a small risk for nephrotoxicity. Entecavir at high doses in rodents was associated with a variety of tumors, prompting the manufacturer to pledge a 10-year follow-up study to establish its long-term safety in humans. Furthermore, currently available hepatitis B treatments are very expensive, and their efficacy in maintaining ...References1. Fisher B, Dignam J, Bryant J, Wolmark N. Five versus more than five years of tamoxifen for lymph node-negative breast cancer: updated findings from the National Surgical Adjuvant Breast and Bowel Project B-14 randomized trial. J Natl Cancer Inst. 2001;93:684-90. [PMID: 11333290] CrossrefMedlineGoogle Scholar2. 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 Scholar3. Stroffolini T, Guadagnino V, Chionne P, Procopio B, Mazzuca EG, Quintieri F, et al. A population based survey of hepatitis B virus infection in a southern Italian town. Ital J Gastroenterol Hepatol. 1997;29:415-8. [PMID: 9494849] MedlineGoogle Scholar4. Sypsa V, Hadjipaschali E, Hatzakis A. Prevalence, risk factors and evaluation of a screening strategy for chronic hepatitis C and B virus infections in healthy company employees. Eur J Epidemiol. 2001;17:721-8. [PMID: 12086089] CrossrefMedlineGoogle Scholar5. Lok AS, McMahon BJ. Chronic hepatitis B. Hepatology. 2007;45:507-39. [PMID: 17256718] CrossrefMedlineGoogle Scholar6. Gish RG, Lok AS, Chang TT, de Man RA, Gadano A, Sollano J, et al. Entecavir therapy for up to 96 weeks in patients with HBeAg-positive chronic hepatitis B. Gastroenterology. 2007;133:1437-44. [PMID: 17983800] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Bulent Degertekin, MD; Anna S.F. Lok, MDAffiliations: From the University of Michigan Health System, Ann Arbor, MI 48109.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? Ching-Lung Lai and Man-Fung Yuen Metrics 1 April 2008Volume 148, Issue 7Page: 560-561KeywordsCancer treatmentDNAHepatitis BMutationNucleosidesPediatric infectionsPolymerase chain reactionSafetySafety studiesViral replication ePublished: 1 April 2008 Issue Published: 1 April 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...