Abstract

Clinical trials and real-world data confirm the efficacy of entecavir treatment for chronic hepatitis B (CHB), however, the factors associated with a favorable response remain unknown. In a retrospective multicenter study, 132 treatment-naïve hepatitis B e antigen (HBeAg)-positive CHB patients (71% male, median age, 40.2 years) received entecavir therapy for >2 years. At baseline, 15% of these patients had cirrhosis. The primary endpoint was HBeAg loss at 2 years of entecavir treatment. The rates of serum alanine aminotransferase (ALT) normalization at treatment Year 1 and Year 2 were 86% and 88%, respectively. The cumulative rate of HBeAg loss at treatment Year 1 and Year 2 were 17% and 33.3%, respectively. The rates of undetectable levels of serum hepatitis B virus (HBV) deoxyribonucleic acid (DNA) at treatment Year 1 and Year 2 were 64% and 80.8%, respectively. In univariate analysis, HBeAg loss at 2 years was associated with a young age (≤35 years, p = 0.007) and a high baseline ALT level (p < 0.001). Multivariate analysis after adjusting for age, sex, and ALT level [>5 times the upper limit of normal (ULN)] showed that a young age (odds ratio, 2.66, 95% confidence interval, 1.2–5.92) and male sex (odds ratio, 0.36, 95% confidence interval, 0.16–0.83) were independent factors associated with HBeAg loss at 2 years of therapy. Two-year entecavir therapy has good biochemical and virologic responses, however, the rate of HBeAg loss is modest in HBeAg-positive CHB patients. A young age (i.e., ≤35 years) and female sex were also associated with a better serologic response.

Abstract

The aim of the present study was to document the knowledge of traditional Siddha medical practitioners from Thiruvarur district in Tamil Nadu, India, and to quantitatively analyze the data to identify some useful leads of medicinal plants and to screening the phytocomounds. Field study was carried out for a period of 1 year in Thiruvarur district of Tamil Nadu. The ethnomedicinal information were collected from Siddha medical practitioners. The collected data were analyzed through quantitative analysis. The molecular docking studies were performed three marketed drugs and eleven different medicinal plant compounds against HBeAg using Schrodinger suite. A total of 33 species of plants distributed in 22 genera belonging to 22 families were identified as commonly used ethno medicinal plants by traditional Siddha practitioners in Thiruvarur. An interesting point in molecular docking study is that luteolin is an effective inhibitor for the inhibition of HBV when compared to commercial drugs. Traditional Siddha medical practitioner and remarkable medicinal plant knowledge and uses were documented for the study area.