[Reuters Health]Long-Term Entecavir Effective for Chronic HBV

StephenW

By Gabriel Miller
NEW YORK (Reuters Health) Jul 13 - Japanese researchers have found that long-term entecavir therapy reduces chronic hepatitis B to undetectable levels in 96% of patients, with only 1.1% experiencing viral breakthrough and less than 0.5% developing resistance.
In addition, there were no serious side effects in a group of patients who received entecavir for four years, according to the new results, published online June 1 in the Journal of Hepatology.
The study included 474 patients with chronic hepatitis B who received the recommended dose of entecavir -- 0.5 mg/day -- for a median of 2.4 years. Seventy-three of these patients were followed for at least four years.
All of the patients were nucleoside-naive and 336 had genotype C, which is common in Asian populations; 67 had genotype B and 12 had genotype A. Among these genotypes, 148, 57 and eight patients, respectively, were hepatitis B e antigen (HBeAg)-positive.
At the end of one year, 88% had undetectable hepatitis B virus DNA (HBV-DNA) levels, and this increased to 96% at four years. Among only HBeAg-positive patients, the figure rose from 75% at year one to 93% at year four.
Treatment failed in five patients, including two who developed entecavir-resistance. All of these patients were positive for HBeAg at baseline and had HBV-DNA serum levels >6 log10 IU/ml.
The investigators, led by Dr. Atsushi Ono at Toranomon Hospital in Tokyo, also did a multivariate analysis to see which factors helped predict response to therapy.
Although multiple factors appeared prognostic at years 1 and 2, only HBV-DNA level was a significant predictor of response at year 3 (<7.6 log10 copies/ml: odds ratio, 15.8; p=0.001).
"The most important factor of long-term entecavir therapy therefore was low HBV-DNA level," the researchers say.
SOURCE: http://bit.ly/N6v8dc                    
J Hepatol 2012.

StephenW

加布里埃尔·米勒

纽约（路透社健康）07月13日 - 日本研究人员发现，长期恩替卡韦治疗慢性乙型肝炎减少96％的患者检测不到的水平，只有1.1％的病毒突破和低于0.5％的发展阻力。

此外，有一组患者接受恩替卡韦4年没有严重的副作用，根据新的成果，肝脏病杂志“刊登在6月1日线上。

这项研究包括慢性乙型肝炎474例患者接受恩替卡韦推荐剂量 - 中位数为2.4年 - 0.5毫克/天。这些患者中有72个，其次为至少四年。

所有的患者，核苷初治和C基因型，这是在亚洲人群中常见的67336有这些基因型，148，57名患者中B基因型和12基因型答：分别是B型肝炎e抗原（ HBeAg）阳性。

在一年年底，88％不到乙肝病毒DNA（HBV-DNA的）的水平，这四年增加96％。其中只有HBeAg阳性患者，这一数字在去年上升75％至93％，第四年。

在5个患者，其中包括两名开发恩替卡韦耐药的治疗失败。所有这些患者在基线HBeAg的阳性和HBV-DNA的血清>6 log10的国际单位/毫升。

的调查，淳大野博士在东京虎门医院领导，也做了一个多变量的分析，看看哪些因素有助于预测治疗反应。

虽然多种因素出现在1年和2年的预后，只有HBV-DNA水平上的反应是在3年的显著预测（<7.6 log10拷贝/毫升：胜算比15.8; P = 0.001）。

“因此，长期恩替卡韦治疗的最重要的因素是低HBV-DNA水平，研究人员说。”

来源：http://bit.ly/N6v8dc

J肝胆病杂志2012。

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