Efficacy of entecavir therapy for hepatitis B e-antigen positive chronic hepatitis B patients with prior exposure to interferon or nucleoside/nucleotide analogues

被引：0

作者：

Tseng, Kuo-Chih ^{[1
,2
]}

Tseng, Chih-Wei ^{[1
,2
]}

Hsieh, Tsai-Yuan ^{[3
]}

Peng, Cheng-Yuan ^{[4
]}

Lin, Chih-Lin ^{[5
]}

Su, Tung-Hung ^{[6
,7
]}

Tseng, Tai-Chung ^{[8
,9
]}

Lin, Hans Hsienhong ^{[8
,9
]}

Wang, Chia-Chi ^{[8
,9
]}

Kao, Jia-Horng ^{[6
,7
]}

机构：

[1] Dalin Tzu Chi Hosp, Dept Internal Med, Buddhist Tzu Chi Med Fdn, Chiayi, Taiwan

[2] Tzuchi Univ, Sch Med, Hualien, Taiwan

[3] Triserv Gen Hosp, Dept Gastroenterol, Taipei, Taiwan

[4] China Med Univ Hosp, Div Hepatogastroenterol, Dept Internal Med, Taichung, Taiwan

[5] Taipei City Hosp, Ren Ai Branch, Dept Gastroenterol, Taipei, Taiwan

[6] Natl Taiwan Univ, Coll Med & Hosp, Grad Inst Clin Med, Taipei, Taiwan

[7] Natl Taiwan Univ, Coll Med & Hosp, Hepatitis Res Ctr, Taipei, Taiwan

[8] Tzu Chi Univ, Buddhist Tzu Chi Med Fdn, Taipei Tzu Chi Hosp, Div Gastroenterol & Hepatol,Dept Internal Med, Hualien, Taiwan

[9] Tzu Chi Univ, Sch Med, Hualien, Taiwan

来源：

HEPATOLOGY RESEARCH | 2016年 / 46卷 / 07期

关键词：

entecavir; hepatitis B virus; lamivudine; HEPATOCELLULAR-CARCINOMA; LAMIVUDINE-RESISTANCE; VIRAL LOAD; FOLLOW-UP; RISK; TENOFOVIR; CIRRHOSIS; DISEASE; IMPACT; LEVEL;

D O I：

10.1111/hepr.12600

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

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.

引用

页码：642 / 649

页数：8

共 24 条

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