Medication Nonadherence with Long-Term Management of Patients with Hepatitis B e

StephenW

<http://www.springerlink.com/content/v854q51119121104/>

Digestive Diseases and Sciences
DOI: 10.1007/s10620-011-1610-5Online First™
Original Article

Medication Nonadherence with Long-Term Management of Patients with Hepatitis B e
antigen-Negative Chronic Hepatitis B

Nghiem B. Ha, Nghi B. Ha, Ruel T. Garcia, Huy N. Trinh, Kevin T. Chaung, Huy A.
Nguyen, Khanh K. Nguyen, Brian S. Levitt and Mindie H. Nguyen

Abstract

Background and Aims  
Antiviral treatment responses for patients with hepatitis B e antigen
(HBeAg)-negative chronic hepatitis B (CHB) are well-defined by data from
registration trials but may differ from patients seen in community settings
where medical adherence is usually not as strictly monitored. The goal of this
study was to examine the long-term outcomes of HBeAg-negative patients in a
community clinical setting.

Methods  
We performed a cohort study of 189 consecutive treatment-naïve patients with
CHB who were treated with either entecavir (ETV) 0.5 mg daily (n = 107) or
adefovir dipivoxil (ADV) 10 mg daily (n = 82) from 2002 to 2009 at two community
clinics.

Results  
All patients were Asians. Both ETV and ADV cohorts had similar median baseline
ALT and HBV DNA levels. By year 4, a similar proportion of ETV and ADV patients
who remained on monotherapy achieved complete viral suppression (91–96%);
however, more patients in the ADV cohort required alternative therapy (27 vs.
5%). No patients in the ETV cohort developed resistance while 18% of the ADV
cohort did. Cumulative nonadherence rates were 10 and 12% in ADV and ETV
cohorts, respectively.

Conclusions  
Failure to monotherapy in a community clinical setting is due to both antiviral
resistance and patient nonadherence. Medication nonadherence is likely to be a
more important contributor to treatment failure than antiviral resistance,
especially with new anti-HBV agents such as ETV and tenofovir.            

消化道疾病与科学
分类号：10.1007/s10620-011-1610-5Online第一™
原创文章

药物未遵从E与长期管理与乙型肝炎患者
抗原阴性慢性乙型肝炎

严乙哈，Nghi二哈，鲁埃尔吨加西亚，郑氏于伊北，羌凯文吨，于伊答
阮，阮庆光，布赖恩学阮Levitt和Mindie阁下

摘要

背景和目的
与乙肝患者抗病毒治疗e抗原反应
（e抗原）阴性慢性乙型肝炎（CHB）是定义良好的数据
登记试验，但可能有所不同的病人在社区环境
通常的医疗坚持不为严格监控。这一目标
研究旨在探讨HBeAg阴性患者的长期结果在一
社区临床设置。

方法
我们完成了189个连续治疗初治患者的队列研究
无论谁是慢性乙型肝炎与恩替卡韦治疗（ETV）0.5毫克每日组（n = 107）或
阿德福韦酯 (ADV)每天10毫克组（n = 82）从2002年至2009年在两个社区
诊所。

结果
所有患者是亚洲人。这两种ETV和ADV同伙也有类似的中位数基准
ALT和HBV DNA水平。到四年级，一个ETV和ADV类似比例的患者
谁仍然取得了圆满的单一病毒抑制（91-96％）;
然而，更多的患者需要治疗的腺病毒替代队列（27主场迎战
5％）。在ETV的队列没有患者产生抗药性，而18％的腺病毒
队列一样。累积未遵从率分别为10和12％，阿德福韦和恩替卡韦
同伙分别。

结论
未能在临床上单一的社会，是因为这两个病毒
阻力和患者未遵从。未遵从药物很可能是一
更重要的贡献比抗病毒治疗性功能衰竭，
尤其是新的抗乙肝病毒等ETV和泰诺福韦。