Assessment of histopathological alterations in patients with chronic hepatitis B infection following long-term oral antiviral therapy

Objectives: To evaluate the histopathological changes in the liver after oral antiviral therapy in patients with chronic hepatitis B. Methods : A total of 79 HBeAg-negative and positive patients who had been on lamivudine, entecavir, or tenofovir disoproxil for at least 3 years prior to inclusion were enrolled between March 2015 and 2016, retrospectively. There were 23 patients on lamivudine, 21 patients on entecavir, and 35 on tenofovir. All patients underwent a follow-up liver biopsy. Biochemical, serological, virological and histopathological data were recorded in all patients and were compared after at least 3 years of treatment with oral antiviral agents. Results : Histological activity index scores were reduced in patients who received lamivudine ( p =0.011), entecavir ( p =0.002), and tenofovir ( p =0.001). Also, in contrast with a significant improvement in fibrosis scores in lamivudine ( p =0.033) and tenofovir ( p =0.001) groups no improvements were found in patients who received entecavir ( p =0.090). Conclusion : Long term treatment with oral antiviral agents was associated with biochemical, virological, serological, and histopathological improvements. Long-term use of anti-viral agents as well as continuous suppression of HBV DNA are prerequisites for histopathological improvement. Saudi Med J 2018; Vol. 39 (10): 999-1005 doi: 10.15537/smj.2018.10.23056 How to cite this article: Şahin A, Namiduru M, Balkan A, Karaoglan I, Gulsen MT. Assessment of histopathological alterations in patients with chronic hepatitis B infection following long-term oral antiviral therapy.  Saudi Med J . 2018 Oct;39(10):999-1005. doi: 10.15537/smj.2018.10.23056.