Efficacy of entecavir treatment among chronic hepatitis B nucleos(t)ide-naïve and -experienced patients

• Published in: Turkish journal of medical sciences Vol. 45; no. 1; pp. 99 - 104
• Main Authors: Biçer, Kadir Çağatay, Ari, Alpay, Genç, Vecdi Evren, Özsu Caymaz, Sibel, Avci, Meltem, Bal, Fatma
• Format: Journal Article
• Language: English
• Published: Turkey 2015
• Subjects: Adult; Antiviral Agents - pharmacology; Antiviral Agents - therapeutic use; DNA, Viral - blood; Drug Resistance, Viral; Female; Guanine - analogs & derivatives; Guanine - pharmacology; Guanine - therapeutic use; Hepatitis B virus - drug effects; Hepatitis B virus - isolation & purification; Hepatitis B, Chronic - drug therapy; Hepatitis B, Chronic - epidemiology; Hepatitis B, Chronic - virology; Humans; Lamivudine - pharmacology; Lamivudine - therapeutic use; Male; Middle Aged; Retrospective Studies; Risk Factors; Treatment Outcome; Viral Load - drug effects
• ISSN: 1300-0144
• DOI: 10.3906/sag-1309-78

To evaluate the efficacy of entecavir (ETV) among chronic hepatitis B (CHB) nucleos(t)ide-naive and -experienced patients in clinical practice.
In this retrospective study 85 CHB patients who had been receiving ETV and who attended our clinic since 2007 were included. Fifty patients were nucleos(t)ide analogue (NA)-naïve. Factors including sex, positive HBeAg, baseline HBV DNA level, baseline alanine aminotransferase level, and prior lamivudine (LAM) resistance were evaluated in terms of their predictive role in treatment response, which was defined as a serum HBV DNA decrease of <31.4 copies/mL.
Resistance was detected in 18 (51.4%) of 35 lamivudine-experienced patients. Virological response (VR) was achieved in 48 (96.0%) of NA-naive patients, while 16 (45.7%) of NA-experienced patients achieved VR. LAM-resistant patients had significantly lower response rates (P < 0.001). More responders with a low initial viral load achieved VR at the end of the 12-month follow-up period compared to those with a high initial viral load (91.7% vs. 70.0%, P = 0.004).
ETV has greater efficacy in NA-naïve patients and in NA-experienced patients without prior LAM resistance. The rate of VR achievement at 12 months was higher in patients who initially had a low viral load with ETV treatment.