On-treatment HBV DNA level could predict HBeAg seroclearance in patients with HBeAg-positive chronic hepatitis B with entecavir therapy.
BACKGROUND
Hepatitis B e antigen (HBeAg) status is associated with clinical outcomes, and seroconversion of HBeAg is one of the treatment goals. In this study, we determined the association of on-treatment serum hepatitis B virus (HBV) DNA levels in HBeAg-positive chronic hepatitis B patients who were receiving entecavir (ETV) treatment.


METHODS
A retrospective cohort study was conducted involving 135 (78 male and 57 female; mean age, 42.3 ± 13 years) patients with HBeAg-positive chronic hepatitis B (CHB). Between August 2008 and March 2014, each patient was treated with ETV for at least 96 weeks, and their HBV DNA levels were evaluated every 3-6 months. HBeAg seroclearance at the 96thweek was defined as an absence of serum HBeAg within 96 weeks after ETV treatment. Univariate and multivariate logistic regression analysis was used to identify the predictors of 96thweek HBeAg seroclearance, and a multivariable model was constructed.


RESULTS
Among the 135 ETV-treated HBeAg-positive CHB patients, 37 patients achieved HBeAg seroclearance (Group 1), whereas 98 patients had persistent HBeAg-positive status (Group 2) at the 96thweek check-up. The baseline laboratory data was not significantly different between both the two groups. At the 24thand 48thweeks, there were significant differences between Group 1 and Group 2 in the percentage of patients with HBV DNA levels < 20 IU/mL [17/77 (22.1%) and 11/23 (47.8%), p = 0.032; 45/89 (50.6%) and 26/35 (74.3%), p = 0.028, respectively).


CONCLUSIONS
Our study demonstrated that HBV DNA levels < 20 IU/mL at the 24thand 48thweeks could predict serum HBeAg loss in ETV-treated HBeAg-positive patients with CHB.
Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
Yi-Jie
YJ
Huang
Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, ROC; School of Medicine, Chung-Shan Medical University, Taichung, Taiwan, ROC.
Chi-Sen
CS
Chang
Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, ROC; National Yang-Ming University, School of Medicine, Taipei, Taiwan, ROC.
Yen-Chun
YC
Peng
Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, ROC; National Yang-Ming University, School of Medicine, Taipei, Taiwan, ROC.
Hong-Zen
HZ
Yeh
Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, ROC; School of Medicine, Chung-Shan Medical University, Taichung, Taiwan, ROC. Electronic address: ssyang2015@gmail.com.
Sheng-Shun
SS
Yang
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use*; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006513:Hepatitis B e Antigens / Q000097:blood*; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016036:Seroepidemiologic Studies; D055815:Young Adult
D000998:Antiviral Agents; D004279:DNA, Viral; D006513:Hepatitis B e Antigens; C413685:entecavir; D006147:Guanine
entecavir; hepatitis B e antigen; hepatitis B virus; hepatitis B virus DNA; seroclearance