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Serological and virological response in patients with hepatitis B virus genotype E treated with entecavir or tenofovir: a prospective study

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Abstract

European clinical practice guidelines (EASL) on chronic hepatitis B (CHB) recently recognized the importance of migration flows in the changing hepatitis B virus (HBV) epidemiology in low-endemic European countries. The role of different genotypes in nucleos(t)ide analogue (NA) treatment is still unknown. In the case of genotype E, which is mainly circulating in West Africa, a quantitative decrease in the level of HBsAg (qHBsAg) during treatment with entecavir (ETV) predicts a longer time to HBsAg loss when compared to genotypes A and D. We prospectively evaluated qHBsAg decline in HBeAg-negative CHB patients infected with HBV genotype E who were treated with tenofovir 245 mg (TDF) or ETV 0.5 mg from 2008 to 2014. Sixty-five West African patients (58; 89.2% males) were enrolled. The median age was 29 years, and the most prevalent route of transmission was familial (25; 38.5%). Median liver stiffness was 7.4 kPa, HBV-DNA was 4.7 Log IU/ml, and qHBsAg was 3.4 Log UI/ml. According to clinical evaluation, 40 patients (61.5%) started ETV treatment, whereas 25 patients (38.5%) started TDF treatment. The decline of qHBsAg in ETV patients was significantly lower than in TDF patients after 5 years of treatment (0.31 vs. 0.68 LogIU/mL, p < 0.001). At the same time points, a significantly higher virological non-response rate was observed in ETV patients (p < 0.001). Despite the partial and non-response rates observed in the ETV group, no mutations associated with drug resistance were detected in these subjects. In genotype E infections, ETV treatment results in a significantly lower decline in qHBsAg and higher rates of virological non-response after 5 years. TDF could represent the optimal choice.

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Abbreviations

HBV:

Hepatitis B virus

NA:

Nucleos(t)ide analogues

CHB:

Chronic hepatitis B

IC:

Inactive carrier

PEG-INF:

Pegylated interferon

HBsAg:

Hepatitis B surface antigen

qHBsAg:

Quantitative HBsAg

ALT:

Alanine aminotransferase

HBeAg:

Hepatitis e antigen

SR:

Sustained response

UNL:

Upper normal level

IQR:

Inter-quartile range

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Author notes

  1. Lucio Boglione and Ilaria De Benedetto contributed equally to this work.

Authors and Affiliations

  1. Department of Translational Medicine (DiMET), University of Eastern Piedmont, Via Solaroli 17, 28100, Novara, Italy

    Lucio Boglione

  2. Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy

    Ilaria De Benedetto, Tommaso Lupia, Jessica Cusato, Giuseppe Cariti & Giovanni Di Perri

Authors
  1. Lucio Boglione
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  2. Ilaria De Benedetto
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  3. Tommaso Lupia
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  4. Jessica Cusato
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  5. Giuseppe Cariti
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  6. Giovanni Di Perri
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Corresponding author

Correspondence to Lucio Boglione.

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All authors declare no conflict of interest.

Ethics approval statement

This study was approved by the local ethics committee as “HBV-Analogues Study” (Prot. N°002360; 26/1/2015) and all included subjects provided written informed consent.

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Handling Editor: Zhongjie Shi.

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Boglione, L., De Benedetto, I., Lupia, T. et al. Serological and virological response in patients with hepatitis B virus genotype E treated with entecavir or tenofovir: a prospective study. Arch Virol 166, 1125–1131 (2021). https://doi.org/10.1007/s00705-021-04992-5

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  • DOI: https://doi.org/10.1007/s00705-021-04992-5

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