scholarly journals Mutational analysis of reverse transcriptase and surface proteins of patients with partial virological response during mono and combination antiviral therapies in genotype D chronic hepatitis B

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2016 ◽  
Vol 8 (6) ◽  
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Seyed Moayed Alavian ◽  
Mehdi Norouzi ◽  
Hossein Keyvani ◽  
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Dong‐Mei Zhang ◽  
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2016 ◽  
Vol 50 (4) ◽  
pp. 338-344 ◽  
Author(s):  
Kevin T. Chaung ◽  
Connor O’Brien ◽  
Nghiem B. Ha ◽  
Nghia H. Nguyen ◽  
Huy N. Trinh ◽  
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Jun Yong Park ◽  
Sang Hoon Ahn ◽  
Do Young Kim ◽  
Kwang-Hyub Han ◽  
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Seung Up Kim ◽  
Chun Kyon Lee ◽  
Jeong Heo ◽  
Ja Kyung Kim ◽  
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Vol 59 (9) ◽  
pp. 5348-5356 ◽  
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Hye Young Chang ◽  
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ABSTRACTThe aims of this study were to investigate the efficacy of prolonged entecavir (ETV) therapy in treatment-naive chronic hepatitis B (CHB) patients and to determine whether continuous ETV therapy is feasible to achieve HBeAg seroconversion, particularly in patients with partial virological response (PVR). A total of 142 treatment-naive patients with CHB were enrolled. The mean duration of treatment was 65 (range, 26 to 90) months, and 86 patients (60.6%) were HBeAg positive. PVR was defined as detectable hepatitis B virus (HBV) DNA (>116 copies/ml) at year 1. The cumulative incidence of virological response (VR) increased from 54.9% at year 1 to 98.2% at year 7. HBeAg positivity (odds ratio [OR], 4.146;P= 0.001) and initial alanine aminotransferase (ALT) (OR, 0.997;P= 0.004) were independent risk factors for PVR. Among the 64 patients with PVR, 47 patients (73.4%) achieved VR within 4 years after prolonged ETV therapy without treatment adaptation. Three patients (2.1%) experienced virological breakthrough and HBV variants with genotypic resistance. The cumulative rate of HBeAg seroconversion was significantly higher in the patients with VR than in the patients with PVR (P= 0.018). None of the PVR patients with HBV DNA at ≥5,000 copies/ml at year 1 ever experienced HBeAg seroconversion. Multivariate analysis identified VR at year 1 as the only determinant of HBeAg seroconversion (hazard ratio [HR], 3.009;P= 0.010). In conclusion, although there were patients with PVR, prolonged ETV therapy showed excellent VR, with only 2.1% emergence of viral resistance during a 7-year follow-up. However, to achieve HBeAg seroconversion, drug modification is needed for HBeAg-positive patients with PVR (especially those with HBV DNA at ≥5,000 copies/ml at year 1).


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