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Long-term follow-up of treatment-naïve HBeAg-negative patients with chronic hepatitis B

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Abstract

Background/aims

We aimed to explore long-term results of oral antiviral agents in treatment-naïve “HBeAg negative chronic hepatitis B (CHB)” and determine the factors affecting the complete virological response.

Method

Patients with HBeAg-negative CHB who used oral antiviral agents for at least 3 years were evaluated retrospectively.

Results

A total of 173 patients were recorded. The mean duration of treatment was 62.2 ± 28.9 months. Complete virological responses (CVR) were 82.8% (n = 53/64) in tenofovir disoproxil fumarate (TDF), 84.4% (n = 49/58) in lamivudine (LAM), 83.9% (n = 26/31) in entecavir (ETV), 95% in telbivudine (LdT) (n = 19/20) (p = 0.290). Multivariate analysis revealed age ≤ 40 (p = 0.012, 95%CI = 1.38–13.76, OR = 4.36) and baseline HBV DNA value (p = 0.003, 95%CI = 1.23–2.63, OR = 1.78) as independent factors for CVR. Virological breakthrough was detected in 29 (50%) patients on LAM therapy, two (6.4%) patients on ETV therapy, and two (10%) patients on LdT therapy. Treatment was switched to another antiviral agent due to osteoporosis in four patients in the TDF group, muscle pain in nine patients in the LDT group, and headache in one patient in the ETV group. Hepatocelluler cancer was detected in five patients. HBsAg seroclearance developed in two patients. Anti-HBs seroconversion was not detected.

Conclusion

CVR was achieved at similar rates with all four antiviral agents, while younger age (≤ 40) and low baseline viral load were the main factors for virological response. However, drug resistance and virological breakthrough in the LAM group and side effects in the LdT group were detected during the long-term follow-up. Moreover, HBsAg seroclearance was achieved at very low rates with oral antiviral agents.

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Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, 34098, Istanbul, Turkey

    Yusuf Emre Ozdemir, Meryem Sahin Ozdemir, Serkan Surme, Sibel Yildiz Kaya, Ridvan Karaali, Ilker Inanc Balkan, Bilgul Mete, Nese Saltoglu & Fehmi Tabak

  2. Department of Public Health, Istanbul Provincial Health Directorate, 34140, Bakırköy, Istanbul, Turkey

    Osman Faruk Bayramlar

Authors
  1. Yusuf Emre Ozdemir
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  2. Meryem Sahin Ozdemir
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All authors read and approved the final manuscript.

Corresponding author

Correspondence to Meryem Sahin Ozdemir.

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Ethics approval

The present study was approved by Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty Clinical Research Ethics Committee (approval date: 01.10.2019, approval no: 83045809–604.01.02). Written informed consent was waived, given the retrospective nature of this study.

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Ozdemir, Y.E., Sahin Ozdemir, M., Bayramlar, O.F. et al. Long-term follow-up of treatment-naïve HBeAg-negative patients with chronic hepatitis B. Ir J Med Sci 192, 633–639 (2023). https://doi.org/10.1007/s11845-022-03066-y

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