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

Myo Nyein Aung^1,2, MBBS, M.Sc., Wattana Leowattana¹, MD, PhD., Noppadon Tangpukdee¹, PhD., Chatporn Kittitrakul¹, MD.

Department of Clinical Tropical Medicine¹, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.

Department of Pharmacology², University of Medicine Mandalay, Myanmar.

  

Citation: Aung MN, Leowattana W, Tangpukdee N, Kittitrakul C. Nucleos(t)ide analogues treatment outcome in genotype B and C chronic hepatitis B. North Am J Med Sci 2010; 2: 365-370.    

Doi: 10.4297/najms.2010.2365

Availability: www.najms.org

ISSN: 1947 – 2714

  

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.

Keywords: Chronic hepatitis B, genotype, treatment, nucleos (t) ide analogues, Thailand.

Correspondence to: Myo Nyein Aung, Department of Pharmacology, University of Medicine, Mandalay, 30^th street, between 73rd and 74th street block, Chan Aye Thar Zan 05071, Mandalay, Myanmar; or TB/HIV Research Foundation, 1050 Sathanpayaban Road, Muang District, Chiang Rai, Thailand 57000. Tel.: +66 53713135,  Fax: +66 53752448, Email: dr.myonyeinaung@gmail.com