Clinical course of patients with insufficient viral suppression during entecavir therapy in genotype C chronic hepatitis B

• Published in: Digestive and liver disease 2013-07, Vol.45 (7), p.600-605
• Main Authors: Bang, Sung-Jo, Kim, Byung Gyu, Shin, Jung Woo, Ju, Hyeong Uk, Park, Bo Ryung, Kim, Min-Ho, Kim, Chang Jae, Park, Jae Ho, Jeong, In Du, Jung, Seok Won, Park, Neung Hwa
• Format: Article
• Language: English
• Subjects: Adult; Antiviral Agents - therapeutic use; Chronic hepatitis B; Disease Progression; Drug Resistance, Viral - genetics; Entecavir; Female; Gastroenterology and Hepatology; Guanine - analogs & derivatives; Guanine - therapeutic use; Hepatitis B e Antigens - immunology; Hepatitis B virus - genetics; Hepatitis B, Chronic - drug therapy; Hepatitis B, Chronic - immunology; Hepatitis B, Chronic - virology; Humans; Longitudinal Studies; Male; Middle Aged; Partial virologic response; Primary non-response; Retrospective Studies; Time Factors; Treatment Failure; Treatment Outcome; Viral Load
• ISSN: 1590-8658; 1878-3562
• DOI: 10.1016/j.dld.2012.12.013

Abstract Background/Aims The clinical course of patients with insufficient virologic suppression diagnosed with chronic hepatitis B undergoing entecavir therapy is unclear. Methods We retrospectively investigated the long-term clinical outcomes of entecavir treatment for more than 12 months in 355 nucleos(t)ide-naïve chronic hepatitis B patients, particularly those with primary non-response or partial virologic response. Results The median duration of entecavir therapy was 40 months (range, 12–64 months). Virologic response was achieved in 315 patients (88.7%). One hundred forty-four (96.6%) of 149 HBeAg-negative patients achieved virologic response. Among 206 HBeAg-positive patients, 52 (25.2%) achieved HBeAg seroconversion. Virologic breakthrough was observed in 7 patients (2.0%). Of these 7 patients, 5 (1.4%) had genotypic resistance to entecavir. Primary non-response and partial virologic response were evident in 6 (1.7%) and 63 (17.7%) patients, respectively. During continuous prolonged entecavir therapy, virologic response of patients with primary non-response and partial virologic response was achieved in 6 (100%) and 28 (44.4%) patients, respectively. Conclusion The vast majority of chronic hepatitis B patients in this study achieved virologic response through prolonged entecavir therapy, with only 1.4% chance of viral resistance. Furthermore, all patients with primary non-response were able to achieve virologic response without adjustment of antiviral therapy.