The role of entecavir in the treatment of chronic hepatitis B

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Therapeutics and Clinical Risk ManagementIssue: 2007, Volume 3, Issue 6

Pages: 1077-1086

The role of entecavir in the treatment of chronic hepatitis B

Evangelini Dimou, Vasilios Papadimitropoulos, Stephanos J Hadziyannis

Department of Medicine and Liver Unit, Henry Dunant Hospital, Athens,

Greece

Abstract: Entecavir (ETV) is a potent and selective inhibitor of hepatitis B

virus replication. In HBeAg-positive and HBeAg-negative lamivudine-naïve

patients with chronic hepatitis B (CHB), treatment with ETV at a dose of 0.5 mg

daily is associated with a more potent viral suppression, a higher rate of

biochemical remission and a greater improvement of liver histology compared to

Lamivudine (LAM). After 3 years of ETV treatment, the majority of patients (94%)

may achieve serum HBV DNA levels undetectable by sensitive PCR assays. ETV

treatment of patients with LAM-resistant HBV mutants requires a higher daily

dose of 1 mg yet, potent HBV suppression at 3 years is achieved only in 40% of

them while the cumulative rate of genotypic HBV resistance increases from 6% in

the first year to>30% in year 3. ETV resistance of HBV is rare in

lamivudine-naïve patients with a reported rate of

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