No significant differences in histology and response to interferon treatment in hepatitis B carriers of genotypes C and recombinant B

Abstract

Hepatitis B virus (HBV) genotypes B and C are most prevalent in China and genotype B is found exclusively in recombination with the pre-C/C gene of genotype C. We investigated whether there is a difference in clinical relevance between the two genotypes sharing the same pre-C/C gene. Thus, we determined the genotype of HBV among consecutive HBeAg-positive patients with tailored interferon-alpha (IFN-alpha) therapy, and the demographic, baseline clinical characteristics and treatment results were compared between them. The median values of alanine transaminase (ALT) were 4.5 and 5.0 times the upper limit of normal (P = 0.419), HBV-DNA levels were 1.4 x 10(7) and 1.5 x 10(7)copies/mL (P = 0.829), mean scores of necroinflammatory histological activity 9.8 and 10.44 (P = 0.105) and fibrotic activity 2.64 and 2.86 (P = 0.227) in genotype B and C patients, respectively. The end-of-treatment response was 42.7% and 39.0% (P = 0.531) with mean tailored treatment months of 8.28 and 9.34 (P = 0.160), and the sustained response 43.4% and 37.5% (P = 0.31) at the end of a 12-month follow-up period in genotype B and C patients, respectively. These results remained similar when follow-up was extended to nearly 3 years. In conclusion, no significant differences in clinical characteristics and response to IFN-alpha between genotypes B and C were found, probably, because both types shared a common pre-C/C encoding region.

Tailored regimen of interferon alpha for HBeAg‐positive chronic hepatitis B: a prospective controlled study

“…This was consistent with that of our recent report [24] and also with that of the pegylated IFNa2a trial, which studied predominantly Asians [20].…”

“…The efficacy of therapy with IFNa for chronic hepatitis B has long been established [2,3] and its long-term benefits have been indisputable [4][5][6][7]. However, the overall outcome is not entirely ideal, because meta-analyses of the results from several trials have shown that the sustained response rate is only 25-40% in HBeAg-positive patients with the traditional regimen of 10 million units (MU) three times a week for [16][17][18][19][20][21][22][23][24] weeks [3,[8][9][10]. In Chinese patients, the response is still more modest and less durable because of the immune tolerance to the virus as a result of infection occurring in early life [11].…”

Relationship between hepatitis B virus genotype B and C and response to interferon therapy in HBeAg positive chronic hepatitis B patients: A meta‐analysis

“…Four studies reported the ETR between the genotype B and C groups. Among these, rates of ALT normalization and HBV DNA negative were reported in four studies, and rates of HBeAg clearance and HBeAg seroconversion were reported in three studies . For rates of ALT normalization, HBV DNA negative and HBeAg clearance, there was significant heterogeneity (Q = 12.97, P = 0.005, I 2 = 76.9%; Q = 12.23, P = 0.007, I 2 = 75.5% and Q = 4.73, P = 0.094, I 2 = 57.8%, respectively); thus, the random effects model was used.…”

“…Nine studies involving 1855 participants (genotype B group = 802, genotype C group = 1053) reported the rate of sustained ALT normalization. Luo et al . reported two outcome data; thus, there were 10 reports of outcome data in the meta‐analysis.…”

“…One review, which evaluated the influence of HBV genotype on the outcome of IFN therapy, has been published before . The review did not include the recent nine studies . An update of the meta‐analysis is needed to provide stronger and more general support the relationship between HBV genotype B and C and response to IFN therapy in HBeAg‐positive CHB patients.…”