Abstract
Current treatment of HBV chronic infection is based on interferon (IFN) or nucleoside/nucleotide analogs (NUCs). Seroconversion and resistance rates were evaluated in 135 HBV patients treated with NUCs alone or NUCs+IFN, during the period 1999-2009. Twenty-seven patients were treated with lamivudine (LAM group), 62 with LAM+IFN for 12 months, followed by lamivudine alone (LAM+IFN group). Patients developing lamivudine resistance were added adefovir (add-on) or switched to entecavir. The remaining 46 naive patients received entecavir (ETV group). HBsAg loss was 0% in the LAM and ETV groups, while it reached 8% in the LAM+IFN group. HBe/anti-HBe seroconversion was 20% with NUCs alone but reached 66.6% with NUC+IFN. In the LAM group, resistance was 74% to lamivudine, 47% to adefovir (add-on) and 20% to entecavir (switch). In the LAM+IFN group, resistance to lamivudine was significantly lower in the first 24 months of treatment, reaching 72% by 84 months. In the ETV group, no virological breakthrough was observed. Our findings suggest a higher percentage of HBe/anti-HBe seroconversion in patients treated with NUCs+IFN as compared to the data reported in the literature when administering interferon or NUCs alone, and substantially confirm the literature data on NUCs resistance.
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