Both authors contributed equally to this work.
Kinetics and prediction of HBsAg loss during therapy with analogues in patients affected by chronic hepatitis B HBeAg negative and genotype D
Article first published online: 14 JAN 2013
© 2012 John Wiley & Sons A/S
Volume 33, Issue 4, pages 580–585, April 2013
How to Cite
Liver Int. 2013: 33: 580–585
- Issue published online: 12 MAR 2013
- Article first published online: 14 JAN 2013
- Accepted manuscript online: 12 DEC 2012 06:04AM EST
- Manuscript Accepted: 21 NOV 2012
- Manuscript Received: 25 JUL 2012
- HBeAg negative;
- HBsAg loss;
- HBV genotype D;
Background & Aims
In patients affected by chronic hepatitis because of HBV infection, long-term suppressive therapy with nucleos(t)ides analogues in the HBeAg− patients has shown low effects on HBsAg titre (qHBsAg) decrease, and HBsAg loss is difficult to achieve. Thus, in this type of patients the main goals of antiviral therapy is the suppression of HBV-DNA and ALT normalization.
We retrospectively evaluated different qHBsAg kinetics in 134 treatment-naïve patients having the same characteristics: HBeAg-, infection sustained by HBV genotype D and persistently undetectable HBV-DNA. Patients were treated with NAs therapy (lamivudine, adefovir, telbivudine, entecavir and tenofovir) for at least 2 years. qHBsAg was performed every 6 months.
Our results showed a significantly greater qHBsAg decline after 2 years in patients treated with tenofovir (0.45 logIU/ml) than in patients treated with telbivudine (0.12 logIU/ml; P < 0.001). The calculated expected time to HBsAg loss was shorter in the tenofovir group than in the telbivudine group (nearly 17 vs 63 years, P < 0.001).
HBeAg negative patients infected by HBV genotype D should be treated with more potent NAs such as entecavir or tenofovir to obtain a significant qHBsAg decrease, but the achievement of HBsAg loss seems to require almost two decades of therapy.