Comparable efficacy of tenofovir versus entecavir and predictors of response in treatment-naïve patients with chronic hepatitis B: A multicenter real-life study


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Batirel A., Guclu E., Arslan F., Kocak F., Karabay O., Ozer S., ...Daha Fazla

International Journal of Infectious Diseases, cilt.28, ss.153-159, 2014 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 28
  • Basım Tarihi: 2014
  • Doi Numarası: 10.1016/j.ijid.2014.09.004
  • Dergi Adı: International Journal of Infectious Diseases
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.153-159
  • Anahtar Kelimeler: Entecavir, Tenofovir, Chronic hepatitis B, HBV, Treatment
  • İstanbul Ticaret Üniversitesi Adresli: Evet

Özet

Objective: To compare responses to tenofovir (TDF) and entecavir (ETV) therapy. Methods: This was a multicenter retrospective study including treatment-naïve patients with chronic hepatitis B (CHB) who received TDF or ETV. The primary end-points were undetectable HBV-DNA at 48 weeks and serological and biochemical responses. Results: Out of 195 CHB patients, 90 (46%) received TDF and 105 (54%) received ETV; 72% were male, their mean age was 43. ±. 12 years, and the mean duration of treatment was 30.2. ±. 15.7 months. Hepatitis B e antigen (HBeAg) seropositivity was 32% in the TDF group and 34% in the ETV group. HBeAg seroconversion rates in HBeAg-positive patients were 24% in the TDF group and 39% in the ETV group; the difference was not significant (. p=. 0.2). The mean time to alanine aminotransferase (ALT) normalization and rates of ALT normalization at 3, 6, 12, 18, and 24 months were similar in the two groups (. p > 0.05). The mean time to undetectable HBV-DNA levels in the TDF and ETV groups was 11.5. ±. 8.9 and 12.9. ±. 10.8 months, respectively (. p=. 0.32). A significantly greater decline in HBV-DNA levels at 12 and 18 months was observed in the TDF group (. p=. 0.02 and p=. 0.03, respectively). Seven (7%) patients on ETV therapy had virological breakthrough (. p=. 0.01). Only one patient in each group had hepatitis B surface antigen (HBsAg) clearance. None of the patients developed decompensation or hepatocellular carcinoma during treatment. Conclusions: The two drugs appear to have similar efficacy in CHB patients. However, 7% of patients on ETV therapy had virological breakthrough, while none of the patients on TDF therapy did.