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Comparison of the efficacies of lamivudine versus entecavir in patients with hepatitis B virus‐related decompensated cirrhosis
Author(s) -
Hyun Jong Jin,
Seo Yeon Seok,
Yoon Eileen,
Kim Tae Hyung,
Kim Dong Jin,
Kang Hyun Seok,
Jung Eun Suk,
Kim Jeong Han,
An Hyonggin,
Kim Ji Hoon,
Yim Hyung Joon,
Yeon Jong Eun,
Lee Hong Sik,
Byun Kwan Soo,
Um Soon Ho,
Kim Chang Duck,
Ryu Ho Sang
Publication year - 2012
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2011.02676.x
Subject(s) - entecavir , lamivudine , medicine , cirrhosis , gastroenterology , hepatitis b virus , hepatitis a virus , hepatitis b , liver function , virus , virology
Background Suppression of hepatitis B virus ( HBV ) DNA is more potent, and occurrence of resistant strain is rare with entecavir than lamivudine, but whether these merits result in a more favourable outcome in HBV ‐related decompensated cirrhosis patients is unclear. Aims To compare virologic response, changes in liver function, clinical course and predictive factors for early mortality after treatment between patients treated with lamivudine and those with entecavir in HBV ‐related decompensated cirrhosis patients. Methods HBV ‐related decompensated cirrhosis patients [Child‐Turcotte‐Pugh ( CTP ) score ≥ 7] treated with either lamivudine or entecavir were enrolled. Serum HBV DNA levels, CTP score and M odel for E nd‐stage L iver D isease ( MELD ) score were monitored every 3 months. Results Eighty‐six patients were enrolled; mean age was 54 ± 11 years, and 63 (73.3%) patients were men; 41 (47.7%) and 45 (52.3%) patients were assigned to the lamivudine group and entecavir group respectively. Although suppression of serum HBV DNA level was more potent in the entecavir group, CTP or MELD scores during the course of treatment did not differ between the two groups. Similarly, 6‐month survival rates did not differ between the two groups (95.1 vs 93.2%, P = 0.684). Baseline CTP score and MELD score at 3 months of treatment were significantly associated with 6‐month mortality. The 6‐ and 12‐month mortality rates for patients with baseline CTP score ≥11 and MELD score ≥17.5 after 3 months of treatment were 42.9 and 61.9% respectively. Conclusions Although HBV DNA suppression was more potent in the entecavir group than the lamivudine group, early mortality rates did not differ between the two groups. The baseline CTP score and MELD score 3 months after initiating antiviral treatment were significant predictors of early mortality.