Seven‐Year Treatment Outcome of Entecavir in a Real‐World Cohort: Effects on Clinical Parameters, HBsAg and HBcrAg Levels. Issue 10 (October 2017)

• Record Type: Journal Article
• Authors: Lam, Yuk‐Fai; Seto, Wai‐Kay; Wong, Danny; Cheung, Ka‐Shing; Fung, James; Mak, Lung‐Yi; Yuen, John; Chong, Chun‐Kong; Lai, Ching‐Lung; Yuen, Man‐Fung
• Is Part Of: Clinical and translational gastroenterology. Volume 8:Issue 10(2017)
• Publication Date: 2017-10
• Subjects: Stomach -- Diseases -- Periodicals; Intestines -- Diseases -- Periodicals; Gastroenterology; Gastrointestinal Diseases; Liver Diseases; Intestines -- Diseases; Stomach -- Diseases; Periodical; Periodicals; Fulltext; Internet Resources; Periodicals; Electronic journals; 616.33
• DOI: 10.1038/ctg.2017.51
• Languages: English
• ISSNs: 2155-384X

Abstract

Abstract : OBJECTIVES: : We aimed to determine the levels of alanine aminotransferase (ALT), hepatitis B virus DNA (HBV DNA), HBsAg, and a novel viral marker (hepatitis B core‐related antigen (HBcrAg)); hepatitis B e antigen (HBeAg) seroconversion and drug resistance rates after 7 years of entecavir treatment in chronic hepatitis B (CHB) patients. METHODS: : Two hundred and twenty‐two Chinese CHB patients on continuous entecavir treatment were recruited. Serologic, virologic, biochemical outcomes, and the occurrence of entecavir signature mutations were determined. RESULTS: : The rates of ALT normalization, HBeAg seroconversion, and undetectable HBV DNA were 98.3%, 82.1%, and 98.7%, respectively, after 7 years of entecavir treatment. The genotypic resistance rate was 1.2%. Decline of HBsAg level was modest with a median decline rate of 0.107 log IU/ml/year. Among patients with baseline HBsAg <1, 000 IU/ml and annual HBsAg decline rate of ≥0.166 log IU/ml, all have HBsAg of <200 IU/ml (a level highly predictive for HBsAg seroclearance) at year 7. In contrast, in patients with baseline HBsAg ≥1, 000 IU/ml and annual HBsAg decline rate of <0.166 log IU/ml, 95.5% had HBsAg of ≥200 IU/ml at year 7. Decline of HBcrAg levels was moderate with a median decline rate of 0.244 log kU/ml/year. Forty‐seven patients (32.0%) had undetectable HBcrAg level at year 7. CONCLUSIONS: : Long‐term entecavir therapy continued to have good responses with low drug resistance rate. However, the decline of HBsAg with treatment was suboptimal. HBcrAg level declined at a relatively better rate. Baseline HBsAg level of <1, 000 IU/ml and annual decline of 0.166 log IU/ml could be used to predict HBsAg response.