Efficacy of entecavir treatment among chronic hepatitis B nucleos(t)ide-naïve and -experienced patients

To evaluate the efficacy of entecavir (ETV) among chronic hepatitis B (CHB) nucleos(t)ide-naïve and -experienced patients in clinical practice. Materials and methods: In this retrospective study 85 CHB patients who had been receiving ETV and who attended our clinic since 2007 were included. Fifty patients were nucleos(t)ide analogue (NA)-naïve. Factors including sex, positive HBeAg, baseline HBV DNA level, baseline alanine aminotransferase level, and prior lamivudine (LAM) resistance were evaluated in terms of their predictive role in treatment response, which was defined as a serum HBV DNA decrease of 31.4 copies/mL. Results: Resistance was detected in 18 (51.4%) of 35 lamivudine-experienced patients. Virological response (VR) was achieved in 48 (96.0%) of NA-naïve patients, while 16 (45.7%) of NA-experienced patients achieved VR. LAM-resistant patients had significantly lower response rates (P 0.001). More responders with a low initial viral load achieved VR at the end of the 12-month follow-up period compared to those with a high initial viral load (91.7% vs. 70.0%, P = 0.004). Conclusion: ETV has greater efficacy in NA-naïve patients and in NA-experienced patients without prior LAM resistance. The rate of VR achievement at 12 months was higher in patients who initially had a low viral load with ETV treatment.