Nucleos(t)ide analogues treatment outcome in genotype B and C chronic hepatitis B

Abstract

Background: Hepatitis B genotypes influence the course and severity of the disease. Aim: To compare the treatment outcome of chronic hepatitis B genotype B and C patients after treating with nucleos(t)ide analogues for six months. Patients and Methods: Forty chronic hepatitis B patients attending the liver clinic of Hospital for Tropical diseases, Bangkok, were studied in retrospective cohort design. Six genotype B patients (15%) and thirty-four genotype C patients (85%) were treated. Serum hepatitis B viral load , serum alanine amino transferase level, HBeAg status and alpha-feto protein level were measured at the time of starting nucleos(t) analogues therapy, and six months later. Besides, achievement of undetectable viral load was assessed in patients with normal serum alanine amino transferase compared to patients with high serum alanine amino transferase level. Results: After six months of nucleos (t) analogues treatment, achievement of undetectable hepatitis B viral load was higher in genotype B patients (66.7%) than in genotype C patients (42.4%) (Relative Risk=1.57, 0.79-3.14). Biochemical remission, HBeAg seroconversion and tumor marker levels between the two groups were not significantly different. Moreover, achievement of undetectable hepatitis B viral load was significantly higher in normal alanine amino transferase level (75%) than in patients with high serum alanine amino transferase level (33.3%) on nucleos(t)ide analogue treatment (Relative Risk=2.25, 1.20- 4.20). Conclusion: Chronic hepatitis B treatment outcome between genotype B and C were not significantly different. Patients with normalized serum alanine amino transferase level tend to achieve undetectable viral load after nucleoside analogues treatment.