The impact of oral antiviral therapy on long-term survival of hepatitis B surface antigen-positive patients on haemodialysis
Evaluates the impact of oral nucleos(t)ide analogues (NA) antivirals on long-term survival of haemodialysis patients infected with chronic hepatitis B (HBV). Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Cre...
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| Published in | New Zealand medical journal Vol. 127; no. 1396; pp. 34 - 42 |
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| Main Authors | , , |
| Format | Journal Article |
| Language | English |
| Published |
New Zealand
Pasifika Medical Association Group (PMAG)
20.06.2014
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| Subjects | |
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| Abstract | Evaluates the impact of oral nucleos(t)ide analogues (NA) antivirals on long-term survival of haemodialysis patients infected with chronic hepatitis B (HBV). Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence. |
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| AbstractList | Hepatitis B (HBV) is an important cause of morbidity and mortality in end-stage renal disease patients. The effect of oral antiviral therapy on survival in this population is not known. We evaluated the impact of oral antivirals on survival of HBV-infected haemodialysis patients.
This retrospective study included 52 HBsAg-positive haemodialysis patients and 156 non-infected haemodialysis controls. Criteria adopted for starting lamivudine were the 2001 American Association for the Study of Liver Diseases guidelines. Lamivudine was commenced in 21 (40.4%) patients, with median treatment duration of 58 months. The primary endpoint was transplant-free survival.
Survival of HBsAg-positive patients was equivalent to that of age- and sex-matched HBsAg-negative controls (39.1% vs 33.2% at 10 years, respectively; P=0.12). In treated patients, complete viral suppression was associated with improved survival (serial HBV DNA less than and equal to 2 log10 IU/mL, 90.9% vs HBV DNA >2 log10 IU/mL on at least one occasion, 74.1% at 5 years; P=0.049). Out of 20 deaths, three were liver-related.
Haemodialysis patients with chronic HBV, when given oral antiviral therapy if indicated, had equivalent long-term survival to that of non-infected controls. In those with active viral hepatitis, viral suppression was associated with reduced liver-related mortality. AIMSHepatitis B (HBV) is an important cause of morbidity and mortality in end-stage renal disease patients. The effect of oral antiviral therapy on survival in this population is not known. We evaluated the impact of oral antivirals on survival of HBV-infected haemodialysis patients.METHODThis retrospective study included 52 HBsAg-positive haemodialysis patients and 156 non-infected haemodialysis controls. Criteria adopted for starting lamivudine were the 2001 American Association for the Study of Liver Diseases guidelines. Lamivudine was commenced in 21 (40.4%) patients, with median treatment duration of 58 months. The primary endpoint was transplant-free survival.RESULTSSurvival of HBsAg-positive patients was equivalent to that of age- and sex-matched HBsAg-negative controls (39.1% vs 33.2% at 10 years, respectively; P=0.12). In treated patients, complete viral suppression was associated with improved survival (serial HBV DNA less than and equal to 2 log10 IU/mL, 90.9% vs HBV DNA >2 log10 IU/mL on at least one occasion, 74.1% at 5 years; P=0.049). Out of 20 deaths, three were liver-related.CONCLUSIONHaemodialysis patients with chronic HBV, when given oral antiviral therapy if indicated, had equivalent long-term survival to that of non-infected controls. In those with active viral hepatitis, viral suppression was associated with reduced liver-related mortality. Aims Hepatitis B (HBV) is an important cause of morbidity and mortality in end-stage renal disease patients. The effect of oral antiviral therapy on survival in this population is not known. We evaluated the impact of oral antivirals on survival of HBV-infected haemodialysis patients. Method This retrospective study included 52 HBsAg-positive haemodialysis patients and 156 non-infected haemodialysis controls. Criteria adopted for starting lamivudine were the 2001 American Association for the Study of Liver Diseases guidelines. Lamivudine was commenced in 21 (40.4%) patients, with median treatment duration of 58 months. The primary endpoint was transplant-free survival. Results Survival of HBsAg-positive patients was equivalent to that of age- and sex-matched HBsAg-negative controls (39.1% vs 33.2% at 10 years, respectively; P=0.12). In treated patients, complete viral suppression was associated with improved survival (serial HBV DNA ?2 log10 IU/mL, 90.9% vs HBV DNA >2 log10 IU/mL on at least one occasion, 74.1% at 5 years; P=0.049). Out of 20 deaths, three were liver-related. Conclusion Haemodialysis patients with chronic HBV, when given oral antiviral therapy if indicated, had equivalent long-term survival to that of non-infected controls. In those with active viral hepatitis, viral suppression was associated with reduced liver-related mortality. Evaluates the impact of oral nucleos(t)ide analogues (NA) antivirals on long-term survival of haemodialysis patients infected with chronic hepatitis B (HBV). Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence. |
| Author | De Zoysa, Janak R Gane, Edward John Ow, Maggie M. G |
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| Snippet | Evaluates the impact of oral nucleos(t)ide analogues (NA) antivirals on long-term survival of haemodialysis patients infected with chronic hepatitis B (HBV).... Hepatitis B (HBV) is an important cause of morbidity and mortality in end-stage renal disease patients. The effect of oral antiviral therapy on survival in... Aims Hepatitis B (HBV) is an important cause of morbidity and mortality in end-stage renal disease patients. The effect of oral antiviral therapy on survival... AIMSHepatitis B (HBV) is an important cause of morbidity and mortality in end-stage renal disease patients. The effect of oral antiviral therapy on survival in... |
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| SubjectTerms | Administration, Oral Aged Antiviral agents Chronic renal failure Female Hemodialysis Hepatitis Hepatitis B Hepatitis B - complications Hepatitis B - drug therapy Hepatitis B Surface Antigens - blood Humans Kaplan-Meier Estimate Kidney Failure, Chronic - complications Kidney Failure, Chronic - therapy Kidney Transplantation Lamivudine - therapeutic use Liver cirrhosis Male Middle Aged Mortality Nucleosides Nucleotides Patients Peritoneal dialysis Proportional Hazards Models Renal Dialysis Retrospective Studies Reverse Transcriptase Inhibitors - therapeutic use Survivors Therapeutic use Transplants & implants |
| Title | The impact of oral antiviral therapy on long-term survival of hepatitis B surface antigen-positive patients on haemodialysis |
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