Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Entecavir/peginterferon alfa-2a combination in the treatment of two genotypes of chronic hepatitis B patients with lamivudine resistance

Xiaoyun Peng¹, Longgui Chen¹, Mingying Xiao²

¹Department Department of Infectious Diseases, Baoshan People's Hospital, Baoshan 678000; China; ²Department of Spleen-Stomach and Liver Diseases, Liuyang Traditional Chinese Medicine Hospital, Liuyang 410300, China.

For correspondence:- Mingying Xiao Email: xiaomingying120@126.com Tel:+868752122054

Accepted: 29 March 2023 Published: 29 April 2023

Citation: Peng X, Chen L, Xiao M. Entecavir/peginterferon alfa-2a combination in the treatment of two genotypes of chronic hepatitis B patients with lamivudine resistance. Trop J Pharm Res 2023; 22(4):901-907 doi: 10.4314/tjpr.v22i4.25

© 2023 The authors.
This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited..

Abstract

Purpose: To investigate the efficacy of entecavir plus peginterferon alfa-2a in the treatment of chronic hepatitis B (CHB) patients with different hepatitis B virus (HBV) genotypes resistant to lamivudine (LAM).

Methods: 119 LAM-resistant CHB patients treated in Baoshan People's Hospital from May 2018 to May 2020 were selected. All patients received entecavir and peginterferon alfa-2a for 24 months and were scheduled for regular outpatient review and telephone follow-up. Polymerase chain reaction (PCR) was conducted to determine the HBV genotype and HBV-DNA clearance. Alanine aminotransferase (ALT) normalization rate, HBV-DNA clearance rates, and hepatitis B e-antigen (HBeAg) seroconversion rate were determined in CHB patients with different genotypes. Quality of life for all patients was assessed using SF-36 Scale.

Results: Five out of 119 patients were lost during follow-up, with a follow-up rate of 95.80 %. Two HBV genotypes were identified, of which 42 (36.8 %) were type B and 72 (63.2 %) type C. At the 6th and 12th month of follow-up, the HBV-DNA clearance rate, ALT normalization rate, and HBeAg seroconversion rate were significantly higher in CHB patients with genotype B than in patients with genotype C (p < 0.05). There were no significant differences between the three rates in the two groups at 18th and 24th month of follow-up (p > 0.05). The quality of life (QOL) of the patients differed between the two groups (p < 0.05).

Conclusion: Entecavir plus peginterferon alfa-2a are effective in treating LAM-resistant CHB patients with different genotypes. Genotype B CHB patients are more suitable for this combination protocol.

Keywords: Peginterferon alfa-2a, Entecavir, Lamivudine resistance, HBV genotypes, virological response