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Sequential therapy with entecavir and PEG‐INF in patients affected by chronic hepatitis B and high levels of HBV‐DNA with non‐ D genotypes
Author(s) -
Boglione L.,
D'Avolio A.,
Cariti G.,
Milia M. G.,
Simiele M.,
Nicolò A.,
Ghisetti V.,
Di Perri G.
Publication year - 2013
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/jvh.12018
Subject(s) - entecavir , medicine , seroconversion , viremia , genotype , serology , hepatitis b virus , pegylated interferon , immunology , chronic hepatitis , hepatitis b , virology , gastroenterology , virus , antibody , biology , ribavirin , lamivudine , biochemistry , gene
Summary Complete eradication of hepatitis B virus ( HBV ) is rarely achieved. Treatment options include currently available nucleos(t)ide analogues and pegylated interferon. The aim of our exploratory study was to assess the effectiveness of sequential therapy for chronic hepatitis B ( CHB ) vs the current standard of care. We evaluated an association with entecavir and pegylated interferon alfa‐2a ( PEG ‐ IFN ) in 20 patients with hepatitis B , high HBV viremia and genotypes A , B , C and E . Patients received entecavir alone for 12 weeks, then entecavir and PEG ‐ IFN for 12 weeks, lastly PEG ‐ IFN alone for 36 weeks. The results were compared with 20 patients (control group) treated in the past with 48 weeks of PEG ‐ IFN monotherapy. Our results show that complete sustained virological response ( SVR ) and partial SVR were, respectively, 60% and 80% in the study group and 10% and 30% in the control group; anti‐ HB e seroconversion rate were 76.9% vs 15%, and anti‐ HB s seroconversion were 20% vs 0%, respectively. We found a correlation among different genotypes and virological and serological outcomes – genotype C has a better virological response, while genotype A had a better serological response, and E genotype had a poor response. These results show that a sequential approach is a promising strategy of treatment in patients with CHB and high viremia in comparison with PEG ‐ IFN monotherapy. The E genotype seems to have the worse rate of response and requires other treatment strategies.