Medication Nonadherence with Long-Term Management of Patients with Hepatitis B e antigen-Negative Chronic Hepatitis B

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http://www.springerlink.com/content/v854q51119121104/

Digestive Diseases and Sciences

DOI: 10.1007/s10620-011-1610-5Online First™

Original Article

Medication Nonadherence with Long-Term Management of Patients with Hepatitis B e

antigen-Negative Chronic Hepatitis B

Nghiem B. Ha, Nghi B. Ha, Ruel T. , Huy N. Trinh, T. Chaung, Huy A.

Nguyen, Khanh K. Nguyen, S. Levitt and Mindie H. Nguyen

Abstract

Background and Aims

Antiviral treatment responses for patients with hepatitis B e antigen

(HBeAg)-negative chronic hepatitis B (CHB) are well-defined by data from

registration trials but may differ from patients seen in community settings

where medical adherence is usually not as strictly monitored. The goal of this

study was to examine the long-term outcomes of HBeAg-negative patients in a

community clinical setting.

Methods

We performed a cohort study of 189 consecutive treatment-naïve patients with CHB

who were treated with either entecavir (ETV) 0.5 mg daily (n = 107) or adefovir

dipivoxil (ADV) 10 mg daily (n = 82) from 2002 to 2009 at two community clinics.

Results

All patients were Asians. Both ETV and ADV cohorts had similar median baseline

ALT and HBV DNA levels. By year 4, a similar proportion of ETV and ADV patients

who remained on monotherapy achieved complete viral suppression (91–96%);

however, more patients in the ADV cohort required alternative therapy (27 vs.

5%). No patients in the ETV cohort developed resistance while 18% of the ADV

cohort did. Cumulative nonadherence rates were 10 and 12% in ADV and ETV

cohorts, respectively.

Conclusions

Failure to monotherapy in a community clinical setting is due to both antiviral

resistance and patient nonadherence. Medication nonadherence is likely to be a

more important contributor to treatment failure than antiviral resistance,

especially with new anti-HBV agents such as ETV and tenofovir.

[Guest guest]

http://www.springerlink.com/content/v854q51119121104/

Digestive Diseases and Sciences

DOI: 10.1007/s10620-011-1610-5Online First™

Original Article

Medication Nonadherence with Long-Term Management of Patients with Hepatitis B e

antigen-Negative Chronic Hepatitis B

Nghiem B. Ha, Nghi B. Ha, Ruel T. , Huy N. Trinh, T. Chaung, Huy A.

Nguyen, Khanh K. Nguyen, S. Levitt and Mindie H. Nguyen

Abstract

Background and Aims

Antiviral treatment responses for patients with hepatitis B e antigen

(HBeAg)-negative chronic hepatitis B (CHB) are well-defined by data from

registration trials but may differ from patients seen in community settings

where medical adherence is usually not as strictly monitored. The goal of this

study was to examine the long-term outcomes of HBeAg-negative patients in a

community clinical setting.

Methods

We performed a cohort study of 189 consecutive treatment-naïve patients with CHB

who were treated with either entecavir (ETV) 0.5 mg daily (n = 107) or adefovir

dipivoxil (ADV) 10 mg daily (n = 82) from 2002 to 2009 at two community clinics.

Results

All patients were Asians. Both ETV and ADV cohorts had similar median baseline

ALT and HBV DNA levels. By year 4, a similar proportion of ETV and ADV patients

who remained on monotherapy achieved complete viral suppression (91–96%);

however, more patients in the ADV cohort required alternative therapy (27 vs.

5%). No patients in the ETV cohort developed resistance while 18% of the ADV

cohort did. Cumulative nonadherence rates were 10 and 12% in ADV and ETV

cohorts, respectively.

Conclusions

Failure to monotherapy in a community clinical setting is due to both antiviral

resistance and patient nonadherence. Medication nonadherence is likely to be a

more important contributor to treatment failure than antiviral resistance,

especially with new anti-HBV agents such as ETV and tenofovir.