Viral load and alanine aminotransferase correlate with serologic response in chronic hepatitis B patients treated with entecavir

Authors

  • Chia-Chi Wang,

    1. School of Medicine, Tzu Chi University, Hualien, Taiwan
    2. Department of Hepatology, Buddhist Tzu Chi General Hospital, Taipei Branch, Taipei, Taiwan
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  • Kuo-Chih Tseng,

    1. School of Medicine, Tzu Chi University, Hualien, Taiwan
    2. Department of Hepatology, Buddhist Tzu Chi General Hospital, Da-Lin Branch, Chiayi, Taiwan
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  • Cheng-Yuan Peng,

    1. Department of Gastroenterology, China Medical University Hospital, Taichung, Taiwan
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  • Tsai-Yuan Hsieh,

    1. Department of Gastroenterology, Tri-service General Hospital, Taipei, Taiwan
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  • Chih-Lin Lin,

    1. Department of Gastroenterology, Taipei City Hospital, Ren-Ai Branch, Taipei, Taiwan
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  • Tung-Hung Su,

    1. Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
    2. Hepatitis Research Center, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
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  • Tai-Chung Tseng,

    1. School of Medicine, Tzu Chi University, Hualien, Taiwan
    2. Department of Hepatology, Buddhist Tzu Chi General Hospital, Taipei Branch, Taipei, Taiwan
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  • Ching-Sheng Hsu,

    1. School of Medicine, Tzu Chi University, Hualien, Taiwan
    2. Department of Hepatology, Buddhist Tzu Chi General Hospital, Taipei Branch, Taipei, Taiwan
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  • Hans Hsienhong Lin,

    1. School of Medicine, Tzu Chi University, Hualien, Taiwan
    2. Department of Hepatology, Buddhist Tzu Chi General Hospital, Taipei Branch, Taipei, Taiwan
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  • Jia-Horng Kao

    Corresponding author
    1. Hepatitis Research Center, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
    • Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
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Correspondence

Professor Jia-Horng Kao, Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, 1 Chang-Te Street, Taipei 100, Taiwan. Email: kaojh@ntu.edu.tw

Abstract

Background and Aim

Although entecavir has been shown to have good efficacy and low resistance for the treatment of chronic hepatitis B (CHB), factors associated with a favorable response remain unknown.

Methods

This was a retrospective, multicenter study of 248 treatment-naïve hepatitis B e antigen (HBeAg)-positive patients (69.4% male; median age, 39.4 years) treated with entecavir for more than 1 year, and 15.7% of them had cirrhosis at baseline. The primary endpoints were HBeAg loss and/or seroconversion.

Results

The median baseline levels of alanine aminotransferase (ALT) and hepatitis B virus (HBV) DNA were 201 U/L (range, 27–2415 U/L) and 7.6 log10 IU/mL (range, 2.2–13.18), respectively. The median treatment period was 25.3 months (range, 12–69.6). The rates of ALT normalization at years 1, 2, and 3 were 83.1%, 87.9%, and 94.9%, respectively. The cumulative rates of HBeAg loss at years 1, 2, and 3 were 20.3%, 38.0%, and 48.9%, respectively. The rates of undetectable HBV-DNA at years 1, 2, and 3 were 52.1%, 78.9%, and 82.5%, respectively. Using Cox proportional hazards model, multivariate analysis showed that baseline ALT greater than five times the upper limit of normal, and viral load were independent factors associated with HBeAg loss (hazard ratio: 1.81, and 0.812; 95% confidence interval: 1.062–3.085; 0.7–0.942, respectively).

Conclusion

Entecavir treatment for 3 years can achieve good biochemical and virologic responses in HBeAg-positive CHB patients, but has a modest effect on HBeAg loss and/or seroconversion. In addition, baseline serum ALT and HBV-DNA levels are independent factors associated with favorable treatment responses.

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