Efficacy and safety of long term entecavir in chronic hepatitis B treatment naïve patients in clinical practice
Journal Title: Annals of Hepatology - Year 2014, Vol 13, Issue 3
Abstract
Background and aims. Entecavir (ETV) is effective and safe in patients with chronic hepatitis B in the short term, but its long term efficacy and safety has not been established. Material and methods. We evaluated HBV DNA clearance, HBeAg/antiHBe and HBsAg/antiHBs seroconversion rates in HBeAg-positive and negative NUC naïve HBV patients treated with ETV for more than 6 months, and predictors of response. Results. A hundred and sixty nine consecutive patients were treated with ETV for a median of 181 weeks. 61% were HBeAg positive, 23% were cirrhotics, and mean HBV-DNA levels were 6,88 ± 1,74 log10 IU/mL. Overall, 156 (92%) patients became HBV DNA undetectable, 92 (88%) HBeAg positive and 64 (98%) HBeAg negative patients. Seventy four (71%) patients cleared HBeAg after a median of 48 weeks of treatment, 23 (14%) patients cleared HBsAg (19 HBeAg positive and 4 HBeAg negative, p 0.025) after a median of 96 weeks of treatment, and 22 (13%) patients developed protective titers of anti-HBs. At the end of the study, 35 (20%) patients had discontinued therapy: 33 HBeAg positive and 2 HBeAg negative; 9 of them (26%) developed virological relapse after a median of 48 weeks of stopping treatment. None of the patients had primary non response and one patient developed breakthrough. Two patients developed HCC, three underwent liver transplantation and 3 deaths were attributable to liver-related events. No serious adverse events were reported. Conclusion. Long term ETV treatment showed high virological response rates, and a favorable safety profile for NUC-naive HBeAg-positive and negative patients treated in clinical practice.
Authors and Affiliations
Ezequiel Ridruejo, Sebastián Marciano, Omar Galdame, María V. Reggiardo, Alberto E. Muñoz, Raúl Adrover, Daniel Cocozzella, Nora Fernandez, Claudio Estepo, Manuel Mendizabal, Gustavo A. Romero, Diana Levi, Teresa Schroder, Silvia Paz, Hugo Fainboim, Oscar G. Mandó, Adrián C. Gadano, Marcelo O. Silva
Keywords
Related Articles
- EP ID EP78393
- DOI -
- Views 104
- Downloads 0
Is pre-treatment liver biopsy necessary for all hepatitis C genotypes?
Background. Current practice guidelines recommend liver biopsy prior to treatment of hepatitis C genotype-1 but not for genotype-2/3; this is based on expert opinion, not on published evidence. Methods. In retrospective...
S-adenosylmethionine metabolism and liver disease
Methionine is an essential amino acid that is metabolized mainly by the liver where it is converted to Sadenosylmethionine (SAMe) by the enzyme methionine adenosyltransferase. Although all mammalian cells synthesize SAMe...
Metabolic syndrome and nonalcoholic fatty liver disease. The role of endothelial progenitor cells
Background. Endothelial dysfunction has been previously described in metabolic syndrome patients. The levels of circulating endothelial progenitor cells (EPCs) inversely correlates with the incidence of cardiovascular di...
Acute liver failure in under two year-olds - are there markers of metabolic disease on admission?
Introduction. The early establishment of an etiology for acute liver failure (ALF) in infants is essential for the start of adequate treatment in the shortest timeframe possible.Aim. To identify markers of inherited meta...
Reversal of advanced fibrosis after long-term ursodeoxycholic acid therapy in a patient with residual expression of MDR3
Introduction. Progressive familial intrahepatic cholestasis type 3 (PFIC-3) is a severe liver disorder associated with inherited dysfunction of multidrug resistance protein 3 (MDR3/ABCB4), which functions as a phospholip...