Tropical Medicine Unit, Hospital de Poniente, Carretera de Almerimar s/n, PD: 07400, Almería, El Ejido, Spain.
Tropical Medicine Unit, Distrito Poniente, Almería, Spain.
BMC Infect Dis. 2018 Nov 14;18(1):568. doi: 10.1186/s12879-018-3469-y.
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.
乙型肝炎病毒（HBV）基因型 E 是一种研究较少的基因型，几乎仅在非洲人群中发现。它似乎具有内在的潜在致癌活性和免疫逃避的病毒学特征，但关于 HBV 基因型 E 感染患者的临床和病毒学特征以及此类患者的抗 HBV 药物疗效的信息很少。来自高乙型肝炎病毒流行的撒哈拉以南非洲地区的移民不断增加，该地区基因型 E 是主要基因型，这使得提高对该地区的认识至关重要，以便提供适当的医疗护理。
这是一项在西班牙热带医学诊所对撒哈拉以南地区的慢性 HBV 基因型 E 感染患者进行的前瞻性观察研究。该研究的目的是描述在真实临床实践中核苷（酸）类似物（NA）、恩替卡韦或替诺福韦治疗慢性 HBV 基因型 E 感染的反应。
在研究期间，我们的热带医学科共为 2209 名撒哈拉以南患者提供了服务，其中 609 名（27.6%）患有慢性乙型肝炎（CHB）感染。有 55 名接受 NA（恩替卡韦或替诺福韦）治疗的初治患者的基因型信息可用，其中 43 名（84.3%）为基因型 E，但其中 15 名因不符合研究纳入标准而被排除。因此，共纳入 28 例慢性 HBV 基因型 E 患者，并至少随访 24 个月。21 例患者处于 HBeAg 阴性慢性肝炎期，7 例患者处于 HBeAg 阳性慢性肝炎期。在治疗 1 年后，在那些依从性好的患者中，17/19（89.4%）例 HBeAg 阴性患者和 80%的 HBeAg 阳性患者的病毒载量均不可检测。在 15-18 个月的随访后，两组的应答率均达到 100%。7 例 HBeAg 阳性患者中，6 例（85.7%）在中位数 31.8 个月时出现 HBeAg 丢失。在研究期间，没有发生严重不良反应或肝癌病例。
HBV 基因型可能影响疾病进展和抗病毒反应。我们的研究提供了有关 NA 治疗 CHB 基因型 E 感染的疗效和安全性的宝贵信息，这是一种具有潜在影响但知之甚少的基因型。
