Source
2nd Department of Internal Medicine, Athens University Medical School, Hippokration Hospital of Athens, Greece; Academic Department of Gastroenterology, Athens University Medical School, Laikon Hospital of Athens, Greece. Electronic address: gepapath@med.uoa.gr.
Abstract
BACKGROUND & AIMS:
Serum HBsAg levels might represent an important predictor of sustained off-treatment response in HBeAg-negative chronic hepatitis B (CHB). We evaluated the changes of HBsAg and interferon-inducible protein 10 (IP10) serum levels in HBeAg-negative CHB patients treated with entecavir.
METHODS:
114 patients received entecavir for a median of 4.3years. HBsAg levels were determined at baseline, 6 and 12months and every year thereafter until year-4. IP10 levels were measured at baseline and annually until year-4 in 76 patients.
RESULTS:
Virological remission rates were high (year-1: 94%, after year-2: 97-98%). Compared to baseline, HBsAg levels decreased by a median of 0.03, 0.13, 0.17, 0.22, and 0.32 log10IU/ml at 6months and 1, 2, 3, and 4years, respectively (p⩽0.001 for all comparisons). The proportions of patients with HBsAg decline of ⩾0.5 or ⩾1 log10IU/ml were 9% or 6% at year-1 and 21% or 10% at the last visit. Median IP10 levels (pg/ml) did not change from baseline to year-1 or -2 (245 vs. 229 or 251), but increased at year-3 and -4 (275 and 323, p<0.030). HBsAg drop ⩾0.5 log10 was associated with baseline IP10 or IP10 >350pg/ml (p⩽0.002). HBsAg loss occurred in 4/114 (3.5%) patients or in 1/2, 3/21, and 0/91 patients with baseline HBsAg <100, 100-1000 and >1000IU/ml, respectively (p<0.001).
CONCLUSIONS:
In HBeAg-negative CHB patients, 4-year entecavir therapy decreases serum HBsAg levels, but the rate of decline is rather slow. Serum IP10 levels represent a promising predictor of HBsAg decline in this setting.
Copyright © 2013 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
KEYWORDS:
ALT, Entecavir, HBV, HBeAg, HBsAg, Hepatitis B, IQR, Interferon-inducible protein 10, LSM, NA(s), PCR, SD, ULN, alanine aminotransferase, anti-HBe, antibody against HBeAg, hepatitis B e antigen, hepatitis B surface antigen, hepatitis B virus, interquartile range, liver stiffness measurement, nucleos(t)ide analogue(s), polymerase chain reaction, standard deviation, upper limit of normal.