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

• Published in: Archives of virology Vol. 166; no. 4; pp. 1125 - 1131
• Main Authors: Boglione, Lucio, De Benedetto, Ilaria, Lupia, Tommaso, Cusato, Jessica, Cariti, Giuseppe, Di Perri, Giovanni
• Format: Journal Article
• Language: English
• Published: Vienna Springer Vienna 01.04.2021; Springer Nature B.V
• Subjects: Adult; Antiretroviral drugs; Antiviral Agents - therapeutic use; Antiviral drugs; Biomedical and Life Sciences; Biomedicine; chronic hepatitis B; clinical examination; decline; Drug resistance; Epidemiology; Female; Genotype; Genotype & phenotype; Genotypes; Guanine - analogs & derivatives; Guanine - therapeutic use; Hepatitis B; Hepatitis B e antigen; Hepatitis B surface antigen; Hepatitis B Surface Antigens - blood; Hepatitis B virus; Hepatitis B virus - drug effects; Hepatitis B virus - genetics; Hepatitis B, Chronic - drug therapy; Hepatitis B, Chronic - virology; Humans; Infectious Diseases; liver; Male; Medical Microbiology; Original Article; Patients; Prospective Studies; Tenofovir; Tenofovir - therapeutic use; Treatment Outcome; Viral Load - drug effects; Virology; Western Africa; Young Adult; Western Africa
• ISSN: 0304-8608; 1432-8798; 1432-8798
• DOI: 10.1007/s00705-021-04992-5

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.