Seroconversion of HBsAg in HBeAg positive and HBeAg negative patients with chronic HBV infection treated with entecavir — a case series from a tertiary care teaching hospital in Eastern India
Journal Title: Journal of the Indian Medical Association - Year 2018, Vol 116, Issue 2
Abstract
The prevalence of chronic HBV infection is increasing in developing countries including India. Experience of seroconversion after treatment with entecavir in patients of chronic HBV infection has been rarely reported. Our aim was to assess the efficacy of HbsAg clearance and persistent seroconversion both in HbeAg positive and HbeAg negative patient after entecavir therapy. This prospective study was conducted in tertiary care hospital in Eastern India from March 2011 to March 2017 on OPD basis. Five HbeAg positive and three HBeAg negative patients (7 males, 1 female, mean age 55.3±14.6 years) amongst 105 patients were eligible for treatment with entecavir 0.5 mg/day. Those patients (n =8) who became HBsAg negative during follow up were included in this case series. Seum alanine transaminase (ALT) levels, HBsAg, Anti-HBsAg, HBeAg and HBV-DNA levels were used to monitor the efficacy of therapy. The main evalution parameters were: time to HBV-DNA clearance, time to HBeAg clearance, time to HBsAg clearance and time to seroconversion (HBsAg clearance followed by appearance of Anti-HBsAg). Detection of HBsAg, Anti-HBsAg, HBeAg in body fluids was performed by Chemilluminescent Microparticle Immunoassay (CMIA). HBV-DNA was measured by real time quantitative PCR. The results were analyzed with descriptive statistics, considering all patients and after stratification for the presence of HBeAg. Overall, the mean time to HBsAg clearance was 33.7±12.8 month. Seroconversion occurred in seven patients (Data of one patient not available), after a mean time of 45.1± 9.3 months. In HBeAg positive, mean time to HBsAg clearance and to seroconversion was 33.2±12.7 and 46±5.4 months, respectively. In HbeAg negative patients, mean time to HBsAg clearance and to seroconversion were 34.6±13.0 and 44±12.7 months respectively. In this case series seroconversion was maintained and was obserbed both in HBeAg positive patients and in HBeAg negative patients. Therefore, it is our observation that suggests treatment with entecavir could be associated to HBsAg seroconversion in a certain period of time, in both HBeAg positive and HBeAg negative chronically HBV infected patients who seldom experience spontaneous seroconversion.
Authors and Affiliations
Kingshuk Kumar Dhar, Pradip Kumar Chowdhury, Supratik Chakraborty, Sujay Ray, Apurba Kumar Pal
Keywords
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