Changes of HBsAg and HBV DNA levels in Chinese chronic hepatitis B patients after 5 years of entecavir treatment. Issue 5 (May 2014)

• Record Type: Journal Article
• Authors: Seto, Wai‐Kay; Lam, Yuk‐Fai; Fung, James; Wong, Danny Ka‐Ho; Huang, Fung‐Yu; Hung, Ivan Fan‐Ngai; Lai, Ching‐Lung; Yuen, Man‐Fung
• Is Part Of: Journal of gastroenterology and hepatology. Volume 29:Issue 5(2014:May)
• Page Start: 1028
• Page End: 1034
• Publication Date: 2014-05
• Subjects: Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Liver Diseases -- Periodicals; 616.33
• DOI: 10.1111/jgh.12476
• Languages: English
• ISSNs: 0815-9319

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jgh12476-sec-0001" sec-type="section"> <title>Background and Aim</title> <p>Hepatitis B surface antigen (HBsAg) kinetics during long‐term entecavir therapy has not been well investigated.</p> </sec> <sec id="jgh12476-sec-0002" sec-type="section"> <title>Methods</title> <p>We described the cumulative serologic, virologic, and biochemical outcomes and the occurrence of signature entecavir mutations among 222 Chinese treatment‐naïve chronic hepatitis B (CHB) patients receiving entecavir for up to 5 years.</p> </sec> <sec id="jgh12476-sec-0003" sec-type="section"> <title>Results</title> <p>The median rate of HBsAg reduction over 5 years was 0.125 log IU/mL/year. Patients with high baseline HBV DNA levels (≥ 8 log copies/mL or ≥ 7.3 log IU/mL), when compared with those with baseline hepatitis B virus (HBV) DNA < 7.3 log IU/mL, had a significantly greater median rate of HBsAg reduction (0.178 and 0.102 log IU/mL/year, respectively, <italic>P</italic> < 0.001). The difference in HBsAg decline was most prominent in the first year (0.324 and 0.062 log IU/mL/year, respectively, <italic>P</italic> < 0.001). Greater median rates of HBsAg reduction were also found in hepatitis B e antigen (HBeAg)‐positive patients when compared with HBeAg‐negative patients (0.144 and 0.098 log IU/mL/year, <italic>P</italic> = 0.015), and in patients with high baseline HBsAg levels (≥ 3 log IU/mL), when compared with patients with low baseline HBsAg < 3 log IU/mL (0.131 and 0.045 log IU/mL/year, respectively, <italic>P</italic> = 0.001). The 5‐year cumulative rate of HBV DNA undetectability (< 20 IU/mL) was 97.1%. There were two cases of entecavir resistance, resulting in a 5‐year cumulative resistance rate of 1.2%.</p> </sec> <sec id="jgh12476-sec-0004" sec-type="section"> <title>Conclusion</title> <p>In contrast to the profound HBV DNA suppression, long‐term entecavir treatment achieved only a slow decline in serum HBsAg. Although certain patient subgroups exhibit a more rapid HBsAg reduction, additional therapeutic agents are needed to increase the chance of HBsAg seroclearance in CHB.</p> </sec> </abstract>