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Kinetics and prediction of HB sAg loss during therapy with analogues in patients affected by chronic hepatitis B HB eAg negative and genotype D
Author(s) -
Boglione Lucio,
D'Avolio Antonio,
Cariti Giuseppe,
Gregori Gabriella,
Burdino Elisa,
Baietto Lorena,
Cusato Jessica,
Ghisetti Valeria,
De Rosa Francesco G.,
Di Perri Giovanni
Publication year - 2013
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.12091
Subject(s) - telbivudine , entecavir , medicine , hbsag , gastroenterology , hbeag , adefovir , lamivudine , genotype , chronic hepatitis , hepatitis b , hepatitis b virus , virology , immunology , virus , biology , gene , biochemistry
Abstract 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 ( qHBsA g) 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. Methods We retrospectively evaluated different qHBsA g 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. qHBsA g was performed every 6 months. Results Our results showed a significantly greater qHBsA g 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). Conclusions HBeAg negative patients infected by HBV genotype D should be treated with more potent NAs such as entecavir or tenofovir to obtain a significant qHBsA g decrease, but the achievement of HBsAg loss seems to require almost two decades of therapy.