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

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.