Evidence map›Paper›PMID 39717508›Full record

ArticleJHEP reports : innovation in hepatology2025

Distinct virologic trajectories in chronic hepatitis B identify heterogeneity in response to nucleos(t)ide analogue therapy.

Tingyan Wang, Cori Campbell, Alexander J Stockdale, Stacy Todd, Karl McIntyre, Andrew Frankland, Jakub Jaworski, Ben Glampson, Dimitri Papadimitriou, Luca Mercuri and 23 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JHEP reports : innovation in hepatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

33 authors.

Tingyan WangNIHR Oxford Biomedical Research Centre, Oxford, UK.
Cori CampbellNIHR Oxford Biomedical Research Centre, Oxford, UK.
Alexander J StockdaleDepartment of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.
Stacy ToddTropical Infectious Diseases Unit, Royal Liverpool Hospital, Liverpool University Hospitals NHS Trust, Liverpool, UK.
Karl McIntyreLiverpool Clinical Laboratories, Liverpool University Hospitals NHS Trust, Liverpool, UK.
Andrew FranklandLiverpool Clinical Laboratories, Liverpool University Hospitals NHS Trust, Liverpool, UK.
Jakub JaworskiCambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Ben GlampsoniCARE Secure Data Environment, Digital Collaboration Space, Imperial College Healthcare NHS Trust, London, UK.
Dimitri PapadimitriouiCARE Secure Data Environment, Digital Collaboration Space, Imperial College Healthcare NHS Trust, London, UK.
Luca MercuriiCARE Secure Data Environment, Digital Collaboration Space, Imperial College Healthcare NHS Trust, London, UK.
Erik MayeriCARE Secure Data Environment, Digital Collaboration Space, Imperial College Healthcare NHS Trust, London, UK.
Christopher R JonesDepartment of Surgery and Cancer, Imperial College London, London, UK.
Hizni SalihNIHR Oxford Biomedical Research Centre, Oxford, UK.
Gail RoadknightNIHR Oxford Biomedical Research Centre, Oxford, UK.
Stephanie LittleNIHR Oxford Biomedical Research Centre, Oxford, UK.
Theresa NobleNIHR Oxford Biomedical Research Centre, Oxford, UK.
Kinga A VárnaiNIHR Oxford Biomedical Research Centre, Oxford, UK.
Cai DavisSouthampton Emerging Therapies and Technologies Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Ashley I HeinsonSouthampton Emerging Therapies and Technologies Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Michael GeorgeSouthampton Emerging Therapies and Technologies Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Florina BorcaSouthampton Emerging Therapies and Technologies Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Louise EnglishNIHR University College London Hospitals Biomedical Research Centre, London, UK.
Luis RomãoNIHR University College London Hospitals Biomedical Research Centre, London, UK.
David RamlakhanNIHR University College London Hospitals Biomedical Research Centre, London, UK.
NIHR HIC Viral Hepatitis and Liver Disease Consortium
Kerrie WoodsNIHR Oxford Biomedical Research Centre, Oxford, UK.
Jim DaviesNIHR Oxford Biomedical Research Centre, Oxford, UK.
Eleni NastouliDepartment of Infection, Immunity and Inflammation, UCL Great Ormond Street Institute of Child Health, London, UK.
Salim I KhakooSchool of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
William GelsonCambridge Liver Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Graham S CookeiCARE Secure Data Environment, Digital Collaboration Space, Imperial College Healthcare NHS Trust, London, UK.
Eleanor BarnesNIHR Oxford Biomedical Research Centre, Oxford, UK.
Philippa C MatthewsNuffield Department of Medicine, University of Oxford, Oxford, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background & Aims: The dynamics of HBV viral load (VL) in patients with chronic hepatitis B (CHB) on nucleos(t)ide analogue (NA) treatment and its relationship with liver disease are poorly understood. We aimed to study longitudinal VL patterns and their associations with CHB clinical outcomes. Methods: Utilising large scale, routinely collected electronic health records from six centres in England, collated by the National Institute for Health and Care Research Health Informatics Collaborative (NIHR HIC), we applied latent class mixed models to investigate VL trajectory patterns in adults receiving NA treatment. We assessed associations of VL trajectory with alanine transaminase, and with liver fibrosis/cirrhosis. Results: We retrieved data from 1,885 adults on NA treatment (median follow-up 6.2 years, IQR 3.7-9.3 years), with 21,691 VL measurements (median 10 per patient, IQR 5-17). Five VL classes were identified from the derivation cohort (n = 1,367, discrimination: 0.93, entropy: 0.90): class 1 'long term suppression' (n = 827, 60.5%), class 2 'timely virological suppression' (n = 254, 18.6%), class 3 'persistent moderate viraemia' (n = 140, 10.2%), class 4 'persistent high-level viraemia' (n = 44, 3.2%), and class 5 'slow virological suppression' (n = 102, 7.5%). The model demonstrated a discrimination of 0.93 and entropy of 0.88 for the validation cohort (n = 518). Alanine transaminase decreased variably over time in VL-suppressed groups (classes 1, 2, 5; all Conclusions: Heterogeneity exists in virological response to NA therapy in CHB patients, with over 20% showing potentially suboptimal responses. Slow virological suppression is associated with liver disease progression. Impact and implications: Treatment recommendations for people living with chronic hepatitis B virus (HBV) infection are becoming less stringent, meaning that more of the population will be eligible to receive therapy with nucleos(t)ide analogue agents. We explored outcomes of HBV treatment in a large UK dataset, describing different responses to treatment, and showing that the viral load is not completely suppressed after 1 year in about one in five cases, associated with an increased risk of liver complications. As treatment is rolled out more widely, patients and clinicians need to be aware of the potential for incomplete virologic responses. The findings can support the identification of high-risk individuals, improve early fibrosis and cirrhosis prediction, guide monitoring and preventive interventions, and support public health elimination goals.

Indexed as

Antiviral treatmentCirrhosisHBVHealth Informatics Collaborative (HIC)Latent class mixed modelsLiver fibrosisLongitudinalNucleotide analogueViral load

Identifiers

PMID39717508
PMCPMC11664071

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.