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Published on: February 19, 2019
Observation of genotype C infected chronic hepatitis B patients in clinical practice
Myo Nyein Aung1, Wattana Leowattana, Noppadon Tangpukdee
1Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. dr.myonyeinaung@gmail.com
Insights
Hepatitis B virus (HBV) genotype C infection in Southeast Asia shows limited response to nucleos(t)ide analogue treatment after one year. Many patients did not achieve virological response or biochemical remission, highlighting a need for improved interventions.
Area of Science:
- Hepatology
- Virology
- Oncology
Background:
- Hepatitis B virus (HBV) genotype C is prevalent in Thailand and Southeast Asia.
- HBV genotype C is a significant risk factor for hepatocellular carcinoma (HCC).
- Chronic hepatitis B (CHB) patients infected with genotype C require further clinical description and treatment response evaluation.
Purpose of the Study:
- To describe baseline clinical characteristics of treatment-naïve genotype C CHB patients.
- To evaluate treatment response using surrogate markers after one year of nucleos(t)ide analogue (NA) therapy in genotype C CHB patients.
Main Methods:
- A study of 34 genotype C CHB patients at the Hospital for Tropical Diseases, Bangkok.
- Patients received lamivudine, telbivudine, adefovir, or entecavir.
- Serum HBV DNA, ALT, HBeAg status, and AFP levels were monitored pre- and post-treatment (12 months). HBV genotyping was done via line-probe assay.
Main Results:
- 58.8% of patients were HBeAg positive at baseline.
- Mean HBV DNA decreased from 6.53 log10 copies/mL to 3.63 log10 copies/mL after one year of NA treatment.
- 47.1% achieved undetectable HBV DNA, and 23.5% had normalized ALT levels.
Conclusions:
- Most genotype C CHB patients in the study were over 40 years old.
- Over half of the patients did not achieve virological response or biochemical remission.
- Genotype C infected CHB patients represent a high-priority group for therapeutic intervention.
Introduction:
Hepatitis B virus (HBV) genotype C is prevalent in many areas of the world including Thailand and Southeast Asia. It is a strong risk for hepatocellular carcinoma (HCC) by evidence. We aimed to describe the baseline clinical information of treatment naïve genotype C infected chronic hepatitis B (CHB) patients and to describe the treatment response by surrogate outcome markers in genotype C infected CHB patients after one year of nucleos(t)ide analogues (NA) treatment
Methodology:
Thirty-four genotype C CHB patients were studied at the Hospital for Tropical Diseases, Bangkok, including 12 patients treated with lamivudine, 11 with telbivudine, 8 with adefovir, and 3 with entecavir. Serum HBV DNA levels, serum alanine amino transferase ( ALT ) levels, HBeAg status, and alpha-feto protein (AFP) levels were recorded at the start and after twelve months of ongoing treatment. HBV genotyping was performed by line-probe assay.
Results:
About half of the patients (58.8%) were HBeAg positive. Mean HBV viral load was 6.53 + 1.15 log10 copies per ml at baseline and reduced to 3.63 + 1.3 log10 copies per ml after one year of NA treatment. Serum HBV DNA levels became undetectable in 47.1 % of the patients and serum ALT was normalized in 23.5 % of the patients.
Conclusion:
Most of the genotype C patients were aged above 40 years. More than half of the genotype C infected patients did not achieve virological response and biochemical remission. Among the CHB patients, genotype C infected patients are a high priority group for intervention.
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