The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Long-term virological outcome in chronic hepatitis B patients with a partial virological response to entecavir

  • Jo, Yu Jung (Department of Internal Medicine, Inje University Ilsan Paik Hospital) ;
  • Kim, Kyung-Ah (Department of Internal Medicine, Inje University Ilsan Paik Hospital) ;
  • Lee, June Sung (Department of Internal Medicine, Inje University Ilsan Paik Hospital) ;
  • Kim, Nam-Hoon (Department of Internal Medicine, Inje University Ilsan Paik Hospital) ;
  • Bae, Won Ki (Department of Internal Medicine, Inje University Ilsan Paik Hospital) ;
  • Song, Tae June (Department of Internal Medicine, Inje University Ilsan Paik Hospital) ;
  • Kim, Jeong Wook (Department of Internal Medicine, Inje University Ilsan Paik Hospital)
  • Received : 2014.02.19
  • Accepted : 2014.06.30
  • Published : 2015.03.01
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Abstract

Background/Aims: 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 $2log_{10}\;IU/mL$, 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 $6.2{\pm}1.5log_{10}\;IU/mL$) 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.

Keywords

References

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