Entecavir treatment for chronic hepatitis B: Adaptation is not needed for the majority of naive patients with a partial virological response

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Entecavir treatment for chronic hepatitis B: Adaptation is not needed for the

majority of naive patients with a partial virological response

Hepatology, 05/13/2011 Clinical Article

Zoutendijk R et al. – Entecavir(ETV) monotherapy can be continued in

nucleos(t)ide analogue–naive patients with a detectable HBV DNA at week 48,

particularly in those with a low viral load at week 48, as long–term ETV leads

to a virological response in the vast majority of patients.

Methods• 333 chronic hepatitis B(CHB) patients treated with entecavir

monotherapy were investigated in a multi- center cohort study .

• Nucleos(t)ide analogue(NA)-naive population consisted of 243 patients, while

90 were NA-experienced.

Results

• Virological response (VR, HBV DNA <80 IU/mL) was achieved in 48%, 76% and 90%

of HBeAg-positive and in 89%, 98% and 99% of HBeAg-negative NA-naive patients at

week 48, 96 and 144, respectively.

• 36 of 175 (21%) NA-naïve patients with at least 48 weeks follow-up had a

detectable load at week 48 (partial virological response, PVR).

• 29 (81%) patients with PVR reached VR during prolonged ETV monotherapy and

none of them developed ETV-resistance.

• Among 22 patients with HBV DNA <1000 IU/mL at week 48, VR was achieved in 21

(95%) patients, compared to eight (57%) of 14 patients with HBV DNA <1000 IU/mL.

• Continuous HBV DNA decline was observed in most patients without VR during

follow-up and in three patients adherence was suboptimal according to the

treating physician.

• ETV was safe and did not affect renal function or cause lactic acidosis.