[HBeAg-positive chronic hepatitis B treatment with oral antiviral agents: experience and results in clinical practice].

Autor:	Martín-Mateos RM; Servicio de Gastroenterología, Hospital Universitario Ramón y Cajal, Madrid, España., Moreira Vicente VF; Servicio de Gastroenterología, Hospital Universitario Ramón y Cajal, Madrid, España., Téllez-Villajos L; Servicio de Gastroenterología, Hospital Universitario Ramón y Cajal, Madrid, España., García-Sánchez C; Servicio de Gastroenterología, Hospital Universitario Ramón y Cajal, Madrid, España., Maroto-Castellanos MT; Servicio de Gastroenterología, Hospital Universitario Ramón y Cajal, Madrid, España., García-Alonso FJ; Servicio de Gastroenterología, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España. Electronic address: rosam.martinma@salud.madrid.org., Mateos-Lindemann ML; Servicio de Microbiología (Virología), Hospital Universitario Ramón y Cajal, Madrid, España., Albillos A; Servicio de Gastroenterología, Hospital Universitario Ramón y Cajal, Madrid, España.
Jazyk:	Spanish; Castilian
Zdroj:	Gastroenterologia y hepatologia [Gastroenterol Hepatol] 2014 May; Vol. 37 (5), pp. 280-8. Date of Electronic Publication: 2014 Jan 24.
DOI:	10.1016/j.gastrohep.2013.11.011
Abstrakt:	Introduction: Due to globalization and migratory movements, HBeAg+ chronic hepatitis B is becoming increasingly important in Spain. Objective: To analyze the epidemiological features, progression, and treatment response to oral antiviral agents (OA) in HBeAg+ chronic hepatitis B patients in our area. Material and Methods: We analyzed 436 patients with chronic hepatitis B infection followed up at the Ramón y Cajal Hospital from 1990 to June 2012. Results: Sixty-five patients (14.9%) had HBeAg+ chronic hepatitis B. Seven patients in the immunotolerant phase were not treated, while the remaining 58 received treatment. Four patients were excluded: two due to severe acute hepatitis, one due to hepatitis C virus coinfection and another because of a Delta virus coinfection. Of the remaining 54 patients, 19 received interferon with or without OA, and 35 received only OA. Two patients treated for less than 1 month were not included in the analysis. The analysis was finally performed in 33 patients. The mean duration of treatment was 46.81 months (6-138). Lamivudine was the most frequently prescribed drug (39.39%) followed by tenofovir (24.24%) and entecavir (21.21%). The mean age was 42.08±14 years and 75.75% (25/33) of the patients were male. Nineteen of 33 patients (57.57%) achieved seroconversion to anti-HBe, and 27.27% (9/33) showed clearance of HBsAg. There was no evidence of HBsAg reversion after a mean follow-up of 35.6 months. There were 8 cases of resistance in 7 patients: 7 to lamivudine and 1 to adefovir. Conclusions: Approximately 15% of chronic hepatitis B patients in our area are HBeAg+. Treatment with OA achieves a high seroconversion rate (57.57%) and a considerable percentage of HBsAg clearance (27.27%). (Copyright © 2013 Elsevier España, S.L. and AEEH y AEG. All rights reserved.)
Databáze:	MEDLINE
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