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partial virological response to three different nucleotide analogues in naive patients with chronic hepatitis B

Hepatobiliary & Pancreatic Diseases International 2014年第6期13卷 602-611页

作者： Ender G Yegin Osman Cavit Ozdogan Department of Gastroenterology Marmara University Faculty of Medicine

BACKGROUND： The definition of partial virological response （PVR） was proposed because of its clinical relevance. PVR relates to subsequent therapeutic failure which results in the modification of the regimen. Whether this rationale can be applied to all nucleotide analogues （NA） is not clear. This study was undertaken to analyze PVR influence on therapeutic outcomes during lamivudine, entecavir or tenofovir mono- therapy in NA-naive patients with chronic hepatitis B in routine clinical practice. METHODS： We retrospectively analyzed 150 NA-naive patients with chronic hepatitis B. These subjects received lamivudine, entecavir or tenofovir monotherapy between February 2001 and July2013. RESULTS： Sixty-nine patients were treated with lamivudine, 35 with entecavir, and 46 with tenofovir. The median therapeutic duration was 19.5 （6-147） months. PVR rates at 24 weeks were similar among three NAs （lamivudine 33.3%, entecavir 35.0%, tenofovir 32.4%, P--0.981）. For all three NAs, patients with a higher baseline viral load or HBeAg-positive status had a higher serum viral positive rate tested by polymerase chain reaction at week 24 and 48. Cumulative probability of virological breakthrough （VBR） for patients treated with lamivudine was 67% at 5 years, and PVR at 24 weeks was the independent risk factor for VBR （HR： 3.09; 95% CI： 1.09-8.74; P=0.034）; also lamivudine treated patients older than 50 years seemed to have a tendency for VBR （HR： 2.80; 95% CI： 0.99-8.18; P=0.052）. A majority of entecavir and tenofovir partial responders achieved and maintained virological response with prolonged monotherapy, except one entecavir treated patient who experienced VBR due to resistance ***： Management strategy for lamivudine treatment should include adaptation of regimen according to PVR as an on-treatment response parameter due to its relation with unacceptably high VBR probability. Similar conclusion should not be directly related to entecavir or tenofovir treatment.

关键词： partial virological response lamivudine entecavir tenofovir therapeutic outcome

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Efficacy of Real-world Entecavir Therapy in Treatment-naive Chronic Hepatitis B Patients

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Chinese Medical Journal 2017年第18期130卷 2190-2197页

作者： Yan-Di Xie Hui Ma Bo Feng Lai Wei Peking University Hepatology Institute Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases Peking University People's HospitalBeijing 100044 China

Background：Entecavir （ETV） has been shown to be effective in randomized controlled trials in highly selected patients with hepatitis B virus （HBV） *** study aimed to evaluate the efficacy of ETV in chronic hepatitis B （CHB） patients in the real-world ***：A total of 233 treatment-na（i）ve,CHB patients who received at least 12 months of ETV treatment were included in this retrospective *** of virological response （VR）,hepatitis B s antigen （HBsAg） loss,hepatitis B e antigen （HBeAg） clearance/seroconversion,virological breakthrough,cirrhosis,and hepatocellular carcinoma were ***：Of 233 patients,175 patients were male,with mean age of 43 years old,and 135 patients were HBeAg *** mean baseline levels of serum alanine aminotransferase and HBV DNA in all patients were 230 U/L and 6.6 log 10 IU/ml,*** mean follow-up period was 28 *** cumulative rates of achieving VR increased from 3.4% at 3 months to 94.4% at 60 *** nonresponse occurred in 3 （1.3%） *** VR （PVR） occurred in 61 （26.2%） patients at 12 *** baseline serum HBV DNA level （hazard ratio [HR],2.054;P 〈 0.001） was an independent risk factor for *** loss did not *** cumulative rates of HBeAg clearance increased from 2.2% at 3 months to 28.2% at 60 *** was the significant determinant of HBeAg clearance （HR,0.341;P =0.026）.Age （HR,1.072;P =0.013） and PVR （HR,5.131;P =0.017） were the significant determinants of ***：ETV treatment was effective for HBV DNA suppression in this study,but HBsAg loss and HBeAg clearance/seroconversion rates were lower compared with previous clinical *** was associated with HBeAg clearance and cirrhosis.

关键词： Entecavir Hepatitis B Virus partial virological response Primary Nonresponse Real-world virological response

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