Nucleos(t)ide analogues treatment outcome in genotype B and C chronic hepatitis B

Abstract

Background:Hepatitis B genotypes influence the course and severity of the disease.Aim:To compare the treatment outcome of chronic hepatitis B genotype B and C patients after treating with nucleos(t)ide analogues for six months.Patients and Methods:Forty chronic hepatitis B patients attending the liver clinic of Hospital for Tropical diseases, Bangkok, were studied in retrospective cohort design. Six genotype B patients (15%) and thirty-four genotype C patients (85%) were treated. Serum hepatitis B viral load, serum alanine amino transferase level, HBeAg status and alpha-feto protein level were measured at the time of starting nucleos(t) analogues therapy, and six months later. Besides, achievement of undetectable viral load was assessed in patients with normal serum alanine amino transferase compared to patients with high serum alanine amino transferase level.Results:After six months of nucleos (t) analogues treatment, achievement of undetectable hepatitis B viral load was higher in genotype B patients (66.7%) than in genotype C patients (42.4%) (Relative Risk=1.57, 0.79-3.14). Biochemical remission, HBeAg seroconversion and tumor marker levels between the two groups were not significantly different. Moreover, achievement of undetectable hepatitis B viral load was significantly higher in normal alanine amino transferase level (75%) than in patients with high serum alanine amino transferase level (33.3%) on nucleos(t)ide analogue treatment (Relative Risk=2.25, 1.20- 4.20).Conclusion:Chronic hepatitis B treatment outcome between genotype B and C were not significantly different. Patients with normalized serum alanine amino transferase level tend to achieve undetectable viral load after nucleoside analogues treatment.

Clinical implication of serum Wisteria floribunda agglutinin positive Mac‐2‐binding protein level on hepatitis B e‐antigen loss or seroconversion in hepatitis B e‐antigen positive patients

“…These results indicate that pretreatment WFA + ‐M2BP level can be helpful for predicting HBeAg loss or HBeAg SC in HBeAg positive CHB patients treated with NUC. On the other hand, our result regarding prognostic significance of pretreatment high viral load of HBV DNA linked to HBeAg SC ( P = 0.0227, HR = 6.374) is in line with previous reports …”

“…In our data, however, the 1‐ and 3‐year cumulative HBeAg SC rates were 8.8% and 29.0%, respectively, which were lower than previously reported data. These may be attributed to differences of baseline characteristics such as race or HBV genotype between studies …”

“…Hepatitis B e‐antigen SC rates in patients treated with ETV were reported to be 12–22% at 1 year, 18–41% at 2 years and 29–44% at 3 years . In our data, however, the 1‐ and 3‐year cumulative HBeAg SC rates were 8.8% and 29.0%, respectively, which were lower than previously reported data.…”

Chronic hepatitis B prognostic markers other than pre-treatment viral load predicted composite treatment outcome

“…A significant association was revealed after adjustment by multivariate multinomial logistic regression (Table 5). Similarly, a previous study reported a significant correlation between ALT normalization at the six month and successful virological outcome at one year among the NA-treated, Thai, CHB patients infected with genotype B and C HBV viruses [30]. The current study result confirmed that ALT normalization at six months after commencing NA treatment significantly predicts undetectable HVB DNA and concomitant biochemical remission and immunological recovery (aRRR 6.67, CI 1.79-24.87).…”