Association of baseline alanine aminotransferase levels with therapeutic effects of entecavir and interferon- in patients with chronic hepatitis B.
10.12122/j.issn.1673-4254.2019.09.04
- Author:
Zhiqi XIAO
1
;
Fuyuan ZHOU
1
;
Bin ZHOU
1
;
Jie YANG
1
Author Information
1. State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
- Publication Type:Journal Article
- Keywords:
alanine aminotransferase;
chronic hepatitis B;
entecavir;
interferon-α
- MeSH:
Alanine Transaminase;
blood;
Antiviral Agents;
therapeutic use;
DNA, Viral;
Guanine;
analogs & derivatives;
therapeutic use;
Hepatitis B Surface Antigens;
blood;
Hepatitis B e Antigens;
blood;
Hepatitis B virus;
immunology;
Hepatitis B, Chronic;
drug therapy;
enzymology;
immunology;
virology;
Humans;
Interferon-alpha;
therapeutic use;
Retrospective Studies;
Time Factors;
Treatment Outcome;
Viral Load;
drug effects
- From:
Journal of Southern Medical University
2019;39(2):150-155
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To evaluate the therapeutic effects of entecavir (ETV) and interferon- (IFN-) treatments for 48 weeks for chronic hepatitis B (CHB) in patients with different baseline alanine aminotransferase (ALT) levels.
METHODS:We retrospectively analyzed the data of 369 CHB patients receiving ETV and IFN- treatments for 48 weeks. We compared the virological response rates, HBsAg clearance, and HBsAg reduction between the patients receiving ETV and IFN- treatments with different baseline ALT levels[≤ 5×upper limits of normal (ULN) level (subgroup 1), 5-10×ULN (subgroup 2), and > 10× ULN (subgroup 3)].
RESULTS:In patients receiving ETV treatment, the virological response rate was 83.3% in subgroup 1, 91.4% in subgroup 2, and 95.5% in subgroup 3, as compared with 19.7%, 40%, and 42.9% in the 3 subgroups with IFN- treatment, respectively, showing significantly differences both among different subgroups with the same treatment and between the same subgroup with different treatments ( < 0.05). HBeAg clearance rates in the 3 subgroups were 8.3%, 16.7% and 35.5% in patients with ETV treatment and were 1.8%, 41.9%, and 38.1% in patients with IFN- treatment, respectively, showing significant differences among the 3 subgroups with the same treatment ( < 0.05); in the same subgroups with different treatments, the rates differed significantly only between subgroups 2 ( < 0.05). In ETV group, the rate of HBsAg reduction to below 200 IU/ml was 2.5% in subgroup 1 and 13.8% in subgroup 2, showing no significant difference between the two subgroups; in IFN- group, the rates were also similar between subgroups 1 and 2 (30.6% 33.3%, > 0.05); but the rates differed significantly between the same subgroups with different treatments ( < 0.05).
CONCLUSIONS:In all the subgroups with different baseline ALT levels, ETV treatment for 48 weeks results in significantly higher virological response rates than IFN- treatment in patients with CHB. In patients with a baseline ALT of 5-10 ×ULN, IFN- can result in a higher HBeAg clearance rate than ETV. In patients with comparable baseline ALT level, IFN- more effectively reduces HBsAg level than ETV. The patients with a relatively high baseline ALT level (> 5 × ULN) show better responses to both ETV and IFN- treatment than those with ALT level below 5×ULN. We thus recommend IFN- for patients with a baseline ALT of 5-10×ULN and ETV for patients with a baseline ALT either below 5 × ULN or beyond 10×ULN.
