Long-term virological outcome in chronic hepatitis B patients with a partial virological response to entecavir.
OBJECTIVE
The clinical outcome of patients with a partial virological response (PVR) to entecavir (ETV), in particular nucloes(t)ide analogue (NA)-experienced patients, has not been thoroughly investigated. The aim of the present study was to assess long-term outcomes in NA-naive and NA-experienced chronic hepatitis B patients with a PVR to ETV.


METHODS
Chronic hepatitis B patients treated with ETV (0.5 mg/day) for at least 1 year were enrolled retrospectively. PVR was defined as a decrease in hepatitis B virus (HBV) DNA titer of more than 2 log10 IU/mL, yet with residual serum HBV DNA, as determined by real time-polymerase chain reaction, at week 48 of ETV therapy.


RESULTS
A total of 202 patients (127 NA-naive and 75 NA-experienced, male 70.8%, antigen positive 53.2%, baseline serum HBV DNA 6.2 ± 1.5 log10 IU/mL) were analyzed. Twenty-eight patients demonstrated a PVR. The PVR was associated with a high serum HBV DNA titer at baseline and at week 24. Virological response (< 60 IU/mL) was achieved in 46.2%, 61.5%, 77.6%, and 85% of patients with PVR at week 72, 96, 144, and 192, respectively. Resistance to antivirals developed in two NA-experienced patients. Failure of virological response (VR) in patients with PVR was associated with high levels of serum HBV DNA at week 48.


CONCLUSIONS
Patients with PVR to ETV had favorable long-term virological outcomes. The low serum level of HBV DNA (< 200 IU/mL) at week 48 was associated with subsequent development of a VR in patients with PVR to ETV.
Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
Yu Jung
YJ
Jo
Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
Kyung-Ah
KA
Kim
Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
June Sung
JS
Lee
Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
Nam-Hoon
NH
Kim
Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
Won Ki
WK
Bae
Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
Tae June
TJ
Song
Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
Jeong Wook
JW
Kim
D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D004279:DNA, Viral / Q000097:blood; D024882:Drug Resistance, Viral; D005260:Female; D006147:Guanine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006515:Hepatitis B virus / Q000187:drug effects* / Q000235:genetics / Q000254:growth & development; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load
D000998:Antiviral Agents; D015415:Biomarkers; D004279:DNA, Viral; C413685:entecavir; D006147:Guanine
Entecavir; Hepatitis B, chronic; Nucleos(t)ide analogue-experienced; Partial virological response