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Efficacy of entecavir therapy for hepatitis B e‐antigen positive chronic hepatitis B patients with prior exposure to interferon or nucleoside/nucleotide analogues
Author(s) -
Tseng KuoChih,
Tseng ChihWei,
Hsieh TsaiYuan,
Peng ChengYuan,
Lin ChihLin,
Su TungHung,
Tseng TaiChung,
Lin Hans Hsienhong,
Wang ChiaChi,
Kao JiaHorng
Publication year - 2016
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12600
Subject(s) - entecavir , medicine , lamivudine , hbeag , gastroenterology , nucleoside analogue , hepatitis b , hepatitis b virus , immunology , hbsag , nucleoside , virology , virus , biology , biochemistry
Aim The efficacy of entecavir (ETV) in treatment‐experienced chronic hepatitis B (CHB) patients remains unclear. We evaluated the therapeutic responses and virological breakthrough following ETV treatment in hepatitis B e‐antigen (HBeAg) positive CHB patients with prior exposure to interferon or nucleoside/nucleotide analog and treatment‐naive patients. Methods This was a retrospective, multicenter study of treatment (>1 year) with 0.5 mg ETV in 248 treatment‐naive and 48 treatment‐experienced HBeAg positive CHB patients (70.5% male; mean age, 40.5 years). The rates of undetectable hepatitis B virus (HBV) DNA, HBeAg loss and virological breakthrough were analyzed. Results The median duration of ETV treatment was 27.3 months (range, 18.4–34.5). The rate of HBeAg loss was 41.9% (104/248) in treatment‐naive and 45.8% (22/48) in treatment‐experienced patients. The baseline serum HBV DNA and alanine aminotransferase levels were significant predictors for HBeAg loss ( P = 0.01 and P = 0.04, respectively). There was no statistical difference between the groups in the rates of undetectable HBV DNA and HBeAg loss at any time point. Virological breakthrough occurred in 1.6% (4/248) of treatment‐naive and 8.3% (4/48) of treatment‐experienced patients. The four treatment‐experienced patients with virological breakthrough had received prior lamivudine treatment. After excluding those treated with interferon, lamivudine‐experienced patients had significantly greater virological breakthrough compared with treatment‐naive patients (log–rank test, P = 0.034; univariate Cox regression, P = 0.047). Conclusion ETV treatment efficacy, including virological response and HBeAg loss, was comparable between treatment‐naive and treatment‐experienced HBeAg positive CHB patients. Lamivudine‐experienced patients had a higher risk of virological breakthrough than treatment‐naive patients.