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Efficacy of switching to entecavir monotherapy in Japanese lamivudine‐pretreated patients
Author(s) -
Suzuki Fumitaka,
Akuta Norio,
Suzuki Yoshiyuki,
Yatsuji Hiromi,
Sezaki Hitomi,
Arase Yasuji,
Hirakawa Miharu,
Kawamura Yusuke,
Hosaka Tetsuya,
Kobayashi Masahiro,
Saitoh Satoshi,
Ikeda Kenji,
Kobayashi Mariko,
Watahiki Sachiyo,
Kumada Hiromitsu
Publication year - 2010
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2009.06161.x
Subject(s) - entecavir , lamivudine , medicine , gastroenterology , viral load , chronic hepatitis , virology , hepatitis b virus , hepatitis b , virus
Background and Aims: To assess the efficacy of switching Japanese chronic hepatitis B patients from lamivudine monotherapy to entecavir 0.5 mg/day. Methods: A retrospective analysis was conducted on 134 patients switched to entecavir between September 2006 and February 2008 for 6 months or more. Patients were divided into three groups based on viral load at entecavir switching point (baseline < 2.6, 2.6–5.0 and > 5.0 log 10 copies/mL). Results: At baseline, detection of lamivudine‐resistant virus was highest in patients with higher hepatitis B virus (HBV) DNA (76% vs 23% in ≥ 2.6 and < 2.6 log 10 copies/mL, respectively), and in patients with longest previous exposure to lamivudine (52%, 28% and 24% for > 3 years, 1–3 years and < 1 year, respectively). Two years after entecavir switching, HBV DNA suppression to less than 2.6 log 10 copies/mL was achieved in 100% (32/32), 92% (12/13) and 44% (4/9) of patients in the less than 2.6, 2.6–5.0 and more than 5.0 log 10 copies/mL baseline groups, respectively. Alanine aminotransferase (ALT) normalization occurred in 76–96% and 90–100% of patients following 1 and 2 years of entecavir treatment, respectively. One patient (2.6–5.0 log 10 copies/mL) with lamivudine‐resistant mutants at baseline developed entecavir resistance at week 48 during follow up. Conclusion: Switching to entecavir 0.5 mg/day achieves or maintains undetectable HBV DNA levels and ALT normalization over 2 years, especially in patients with viral load less than 5.0 log 10 copies/mL.