Factors associated with HBV virological breakthrough

Sheppard-Law, S; Zablotska-Manos, I; Kermeen, M; Holdaway, S; Lee, A; Zekry, A; Dore, GJ; George, J; Maher, L

Factors associated with HBV virological breakthrough

Sheppard-Law, S

Zablotska-Manos, I Kermeen, M Holdaway, S Lee, A Zekry, A Dore, GJ George, J Maher, L

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Publication Type:: Journal Article
Citation:: Antiviral Therapy, 2017, 22 (1), pp. 53 - 60
Issue Date:: 2017-01-01

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Field	Value	Language
dc.contributor.author	Sheppard-Law, S https://orcid.org/0000-0002-9971-9343	en_US
dc.contributor.author	Zablotska-Manos, I	en_US
dc.contributor.author	Kermeen, M	en_US
dc.contributor.author	Holdaway, S	en_US
dc.contributor.author	Lee, A	en_US
dc.contributor.author	Zekry, A	en_US
dc.contributor.author	Dore, GJ	en_US
dc.contributor.author	George, J	en_US
dc.contributor.author	Maher, L	en_US
dc.date.available	2020-05-25T19:23:31Z
dc.date.issued	2017-01-01	en_US
dc.identifier.citation	Antiviral Therapy, 2017, 22 (1), pp. 53 - 60	en_US
dc.identifier.issn	1359-6535	en_US
dc.identifier.uri	http://hdl.handle.net/10453/59182
dc.description.abstract	©2017 International Medical Press. Background: Little is known about non-adherence to HBV therapy. This study aimed to investigate the relationship between self-reported missed days of antiviral therapy and HBV virological breakthrough and factors associated with virological breakthrough. Methods: A cross-sectional survey of 211 HBV patients receiving oral antiviral therapies was undertaken at three tertiary hospitals in Sydney, Australia. Associations between 0 to >6 missed days in the last 30 days and virological breakthrough (defined as >10-fold rise in serum HBV DNA above nadir or after achieving virological response in the last 12 months) were examined. Logistic regression analyses determined the number of missed days most strongly associated with virological breakthrough and the associated factors. We report odds ratios (ORs) and relative risks (RRs). Results: Of the 204, 32 participants (15.6%) had quantifiable HBV DNA levels (>20 IU/ml); 15 (46.8%) of them experienced virological breakthrough. Participants reported never missing medication (n=130, 63.7%) or missing 1 day (n=23, 11.3%), >1 day (n=23, 11.3%), 2-6 days (n=15, 7.3%) and >6 days (n=13, 6.4%). The most discriminating definition of non-adherence was missing >1 day of medication (RR=8.3; OR=10.2, 95% CI 3.1, 33.8, receiver operating characteristic curve 0.76). Factors independently associated with virological breakthrough included non-adherence (OR=9.0, 95% CI 2.5, 31.9) diagnosed with HBV ≤14 years (OR=5.3, 95% CI 1.0, 26.2) and age ≤47 years (OR=5.4, 95% CI 1.1, 26.9). Conclusions: Results provide an evidence-based definition of non-adherence to inform clinical practice and provide a basis for key patient education messages. Closer monitoring of groups at risk of viral breakthrough is required.	en_US
dc.relation.ispartof	Antiviral Therapy	en_US
dc.relation.isbasedon	10.3851/IMP3087	en_US
dc.subject.classification	Virology	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Hepatitis B virus	en_US
dc.subject.mesh	Hepatitis B, Chronic	en_US
dc.subject.mesh	DNA, Viral	en_US
dc.subject.mesh	Antiviral Agents	en_US
dc.subject.mesh	Treatment Failure	en_US
dc.subject.mesh	Viral Load	en_US
dc.subject.mesh	Risk Factors	en_US
dc.subject.mesh	Cross-Sectional Studies	en_US
dc.subject.mesh	Evidence-Based Medicine	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Medication Adherence	en_US
dc.subject.mesh	Young Adult	en_US
dc.subject.mesh	Self Report	en_US
dc.subject.mesh	Sustained Virologic Response	en_US
dc.title	Factors associated with HBV virological breakthrough	en_US
dc.type	Journal Article
utslib.citation.volume	1	en_US
utslib.citation.volume	22	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	0605 Microbiology	en_US
utslib.for	1108 Medical Microbiology	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	open_access
pubs.issue	1	en_US
pubs.publication-status	Published	en_US
pubs.volume	22	en_US

Abstract:

©2017 International Medical Press. Background: Little is known about non-adherence to HBV therapy. This study aimed to investigate the relationship between self-reported missed days of antiviral therapy and HBV virological breakthrough and factors associated with virological breakthrough. Methods: A cross-sectional survey of 211 HBV patients receiving oral antiviral therapies was undertaken at three tertiary hospitals in Sydney, Australia. Associations between 0 to >6 missed days in the last 30 days and virological breakthrough (defined as >10-fold rise in serum HBV DNA above nadir or after achieving virological response in the last 12 months) were examined. Logistic regression analyses determined the number of missed days most strongly associated with virological breakthrough and the associated factors. We report odds ratios (ORs) and relative risks (RRs). Results: Of the 204, 32 participants (15.6%) had quantifiable HBV DNA levels (>20 IU/ml); 15 (46.8%) of them experienced virological breakthrough. Participants reported never missing medication (n=130, 63.7%) or missing 1 day (n=23, 11.3%), >1 day (n=23, 11.3%), 2-6 days (n=15, 7.3%) and >6 days (n=13, 6.4%). The most discriminating definition of non-adherence was missing >1 day of medication (RR=8.3; OR=10.2, 95% CI 3.1, 33.8, receiver operating characteristic curve 0.76). Factors independently associated with virological breakthrough included non-adherence (OR=9.0, 95% CI 2.5, 31.9) diagnosed with HBV ≤14 years (OR=5.3, 95% CI 1.0, 26.2) and age ≤47 years (OR=5.4, 95% CI 1.1, 26.9). Conclusions: Results provide an evidence-based definition of non-adherence to inform clinical practice and provide a basis for key patient education messages. Closer monitoring of groups at risk of viral breakthrough is required.

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http://hdl.handle.net/10453/59182