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The Antiviral Effects of Entecavir in Nucleos(t)ide Analogue-experienced Chronic Hepatitis B Patients
Guang Dong Tong, Da Qiao Zhou, Hai Hong Tang, Chun Shan Wei, Jin Song He, Ying Jun Zheng, Mei Qiu, Liang Chen, Xiao Zhou Zhou, Wen Jun Xu
Hepatology, Shenzhen Hospital of Traditional Chinese Medicine, Shenzhen, China
Background/aim: The antiviral effects of ETV-monotherapy were monitored clinically in NA-experienced patients during a median follow-up of 48 months.
Methods: We investigated 212 CHB patients treated with ETV-monotherapy in a cohort study. Among the 104 NA-experienced patients, 84 (including 44 LAM-resistant) were LAM-experienced, and 58 (including 38 ADV-resistant) were ADV-experienced. Rescue therapy (TDF or ADV add-on with ETV) were used for patients with suboptimal response (defined as HBV-DNA >500 copies/ml at a follow-up of 2 years) to ETV or viral breakthrough.
Results: 96% NA-naïve patients exhibited VR(HBV-DNA< 500 copies/ml), whereas only 68% NA-experienced patients exhibited VR, while 13% NA-experienced patients showed suboptimal response to ETV-monotherapy and 18% NA-experienced patients with ETV-monotherapy developed viral breakthrough during a median follow-up of 48 (6-69) months. LAM-experienced patients with LAM-R treated with ETV-monotherapy exhibited significantly decreased VR compared with LAM-naïve patients (HR=0.163; P=0.0013). However, the antiviral efficacy of ETV was not decreased for LAM-experienced patients without LAM-R (HR=0.63; P=0.584). In ADV-experienced patients, the antiviral effect of ETV-monotherapy was unaffected compared with ADV-naïve patients regardless whether ADV-R was developed (HR=0.58; P=0.253) or not (HR 0.28; P=0.52). 14 patients with suboptimal response received rescue therapy (6 with TDF and 8 with ADV add-on), and 13 (93%) patients exhibited VR during a median follow-up of 20 (15-32) months. 19 patients with viral breakthrough also received rescue therapy (9 with TDF and 10 with ADV add-on), and 16 (84%) patients exhibited VR during a median follow-up of 19 (16-28) months.
Conclusion: The antiviral efficacy of ETV was not affected by either the prior ADV treatment or LAM treatment without LAM-R for a follow-up of 48 months. Patients with LAM-R exhibited lower VR rate than LAM-naïve patients. For patients who failed to show VR by ETV- monotherapy, co-administration of ADV or TDF still could achieve VR.
Assigned speakers:
Prof. Guang Dong Tong, Shenzhen Hospital of Traditional Chinese Medicine , Shenzhen , China
Assigned in sessions:
07.06.2013, 08:30-17:30, PT-4, HEP B Clinical, Exhibition Hall
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