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Master Thesis

Fréquence et signification des blips au cours du traitement de l’hépatite B par analogues de deuxième génération

Abstract : The frequency and significance of blips is not well known in patients with chronic hepatitis B treated with nucleoside analogues. The aim of the study was to assess the incidence, risk factors and clinical impact of these blips. 141 patients were included in this single-center study. Monitoring was quarterly. A blip was defined as HBV DNA>20 IU/ml. Pharmacological assays were performed at the time of blips. Patient characteristics: median age 47 years, men 72.3%, HBV DNA 6.1 log IU/ml, HBeAg (+) 25.5%, ALT 38 IU/ml. ETV was sick (37%), TDF (50%), or ETV + TDF (13%). Virologic response was observed in M12 in 85.6% of cases, the occurrence of at least one blip was observed in 34 (24%) of patients. The median time from the beginning of treatment was 28.5 months (6-74). These blips were unique in 23 cases and followed by one or more other blips in 11 cases. The median HBV DNA when blip was 29 IU/ml. Factors significantly associated with the occurrence of a blip were HBeAg (+) initial (41.2% vs 20.6%, p=0.016); high viral load, a period of negativity longer and always positive viral load at M12 (60% vs 15%, p<0.001). A failure to compliance was not associated with blips. The presence of these blips was not associated with a difference on the biochemical response, serologic or on the development of fibrosis monitored by measuring the elasticity of the liver or to the occurrence of hepatic events. This study shows that the blips are more common in patients with a slow virologic response.
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Master Thesis
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Submitted on : Thursday, December 18, 2014 - 2:34:13 PM
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  • HAL Id : dumas-01096918, version 1


Aude Montchaud. Fréquence et signification des blips au cours du traitement de l’hépatite B par analogues de deuxième génération. Médecine humaine et pathologie. 2014. ⟨dumas-01096918⟩



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