Publication: Chronic hepatitis B genotype E in African migrants: response to nucleos(t)ide treatment in real clinical practice.
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Identifiers
Date
2018-11-14
Authors
Cuenca-Gómez, José Ángel
Lozano-Serrano, Ana Belén
Cabezas-Fernández, María Teresa
Soriano-Pérez, Manuel Jesús
Vázquez-Villegas, José
Estévez-Escobar, Matías
Cabeza-Barrera, Isabel
Salas-Coronas, Joaquín
Advisors
Journal Title
Journal ISSN
Volume Title
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Abstract
Hepatitis B virus (HBV) genotype E is a poorly studied genotype that almost exclusively occurs in African people. It seems to harbour intrinsic potential oncogenic activity and virological characteristics of immune scape but a paucity of information is available on clinical and virological characteristic of HBV genotype E-infected patients as well as on the efficacy of anti-HBV drugs for such patients. The increasing flow of migrants from high endemic HBV sub-Saharan Africa, where genotype E is the predominant one, to Western countries makes improving such knowledge critical in order to deliver proper medical care. Prospective observational study of naïve patients of sub-Saharan origin treated for chronic HBV genotype E infection at a Tropical Medicine clinic sited in Spain from February 2004 to January 2018. The aim of the study was to describe the response of chronic HBV genotype E infection to nucleos(t)ide analogues (NA), entecavir or tenofovir, in real clinical practice. During the study period, 2209 sub-Saharan patients were assisted at our Tropical Medicine Unit and 609 (27.6%) had chronic HBV (CHB) infection. Genotype information was available for 55 naïve patients initiating treatment with NA (entecavir or tenofovir), 43 (84.3%) of them being genotype E, although 15 were excluded because they did not meet study inclusion criteria. Thus, a total of 28 CHB genotype E patients were included and followed for 24 months at least. Twenty-one patients were in HBeAg-negative chronic hepatitis phase and 7 patients in HBeAg-positive chronic hepatitis phase. After one year of treatment, among those with good adherence, 89.4% (17/19) of the HBeAg-negative patients and 80% of the HBeAg-positive ones had undetectable viral loads. Response rates reached 100% in both groups after 15-18 months of follow-up. Out of the 7 HBeAg-positive patients, 6 (85.7%) presented HBeAg loss in a median time of 31.8 months. Neither serious adverse effects nor hepatocarcinoma cases happened during the study period. HBV genotype may influence disease progression and antiviral response. Our study provides precious information on the efficacy and safety of NA treatment for CHB genotype E infection, a fairly unknown genotype with and increasing epidemiological impact.
Description
MeSH Terms
Adult
Africa South of the Sahara
Antiviral Agents
Drug Resistance, Viral
Female
Genotype
Guanine
Hepatitis B e Antigens
Hepatitis B virus
Hepatitis B, Chronic
Humans
Male
Nucleosides
Nucleotides
Practice Patterns, Physicians'
Spain
Tenofovir
Transients and Migrants
Treatment Outcome
Viral Load
Africa South of the Sahara
Antiviral Agents
Drug Resistance, Viral
Female
Genotype
Guanine
Hepatitis B e Antigens
Hepatitis B virus
Hepatitis B, Chronic
Humans
Male
Nucleosides
Nucleotides
Practice Patterns, Physicians'
Spain
Tenofovir
Transients and Migrants
Treatment Outcome
Viral Load
DeCS Terms
CIE Terms
Keywords
African migrants, Entecavir, Genotype E, Hepatitis B, Tenofovir