Observation of genotype C infected chronic hepatitis B patients in clinical practice

Abstract

Introduction: Hepatitis B virus (HBV) genotype C is prevalent in many areas of the world including Thailand and Southeast Asia. It is a strong risk for hepatocellular carcinoma (HCC) by evidence. We aimed to describe the baseline clinical information of treatment naïve genotype C infected chronic hepatitis B (CHB) patients and to describe the treatment response by surrogate outcome markers in genotype C infected CHB patients after one year of nucleos(t)ide analogues (NA) treatment

Methodology:  Thirty-four genotype C CHB patients were studied at the Hospital for Tropical Diseases, Bangkok, including 12 patients treated with lamivudine, 11 with telbivudine, 8 with adefovir, and 3 with entecavir. Serum HBV DNA levels, serum alanine amino transferase ( ALT ) levels, HBeAg status, and alpha-feto protein (AFP) levels were recorded at the start and after twelve months of ongoing treatment. HBV genotyping was performed by line-probe assay.

Results: About half of the patients (58.8%) were HBeAg positive. Mean HBV viral load was 6.53 + 1.15 log₁₀ copies per ml at baseline and reduced to 3.63 + 1.3 log₁₀ copies per ml after one year of NA treatment. Serum HBV DNA levels became undetectable in 47.1 % of the patients and serum ALT was normalized in 23.5 % of the patients.

Conclusion: Most of the genotype C patients were aged above 40 years. More than half of the genotype C infected patients did not achieve virological response and biochemical remission. Among the CHB patients, genotype C infected patients are a high priority group for intervention.