Early HBeAg Decrease Predicts Response to Entecavir (Baraclude) for Hepatitis B

StephenW

http://www.hivandhepatitis.com/hepatitis-b/hepatitis-b-topics/hbv-treatment/3138-early-hbeag-decrease-predicts-virological-response-to-entecavir-baraclude-for-hepatitis-b
Early HBeAg Decrease Predicts Response to Entecavir (Baraclude) for Hepatitis B
Category: HBV Treatment
Published on Tuesday, 09 August 2011 00:00
Written by Liz Highleyman   
HBV © Russell Kightley           
                                                                                                
               
Decreases in hepatitis B "e" antigen (HBeAg) during the first 6 months of treatment with entecavir (Baraclude) are a better indicator than hepatitis B virus (HBV) DNA levels of which patients will go on to achieve HBeAg seroconversion, according to a recent Chinese study.

Response to treatment for chronic hepatitis B may be assessed in different ways: virological response or decrease in HBV viral load, biochemical response or normalization of ALT levels, and serological response or loss of HBV antigens and antibodies in the blood.

As described in the July 2011 Journal of Viral Hepatitis, X. Zhang from Xi'an Jiaotong University and colleagues sought to determine whether measurement of HBeAg at baseline and while on treatment could predict which patients would achieve HBeAg seroconversion after 2 years on entecavir.
Quantification of HBeAg levels has been shown to be useful for monitoring and predicting outcomes of treatment with interferon and lamivudine (Epivir-HBV) in HBeAg positive patients, but it is unclear whether this also holds true for entecavir, the authors noted as background.
This analysis included 65 HBeAg positive, treatment-naive chronic hepatitis B patients who were treated with 0.5 mg once-daily entecavir for 96 weeks. The researchers measured serum HBV DNA viral load levels at baseline and at weeks 24, 48, and 96; serum HBeAg levels were assessed more often, at weeks 12, 24, 48, 72, and 96.
Results

• Serum HBeAg levels were more closely associated with a higher likelihood of HBeAg seroconversion at 96 weeks than serum HBV DNA levels at baseline or on treatment.
• A sustained reduction in HBeAg by more than 65% of the pre-treatment level after 24 weeks on entecavir was the strongest predictor of HBeAg seroconversion at 96 weeks.
  

        
Based on these findings, the study authors concluded, "Quantification of HBeAg at the start and early during therapy showed a higher predictive value than that of HBV DNA for HBeAg seroconversion by entecavir."
"A significant decrease in serum HBeAg levels at week 24 may be a useful on-treatment measurement in the early phase for predicting HBeAg seroconversion and identifying patients who will most likely benefit from finite entecavir treatment," they added.
Investigator affiliation: Department of Infectious Diseases, First Affiliated Hospital of Medical College of Xi'an Jiaotong University, Shaanxi Province, China.
8/9/11
Reference
X Zhang, S-M Lin, F Ye, et al. An early decrease in serum HBeAg titre is a strong predictor of virological response to entecavir in HBeAg-positive patients. Journal of Viral Hepatitis 18(7):e184-190 (abstract). July 2011.