Long-term entecavir therapy results in the reversal of fibrosis/cirrhosis

StephenW

Hepatology. 2010 Jun 1. [Epub ahead of print]

Long-term entecavir therapy results in the reversal of fibrosis/cirrhosis and
continued histological improvement in patients with chronic hepatitis B.

Chang TT, Liaw YF, Wu SS, Schiff E, Han KH, Lai CL, Safadi R, Lee SS, Halota
W, Goodman Z, Chi YC, Zhang H, Hindes R, Iloeje U, Beebe S, Kreter B.

National Cheng Kung University Medical College, Tainan, Taiwan.

Abstract
One year of treatment with entecavir (0.5 mg daily) in nucleoside-naive
patients with hepatitis B e antigen (HBeAg)-positive or HBeAg-negative chronic
hepatitis B (CHB) resulted in significantly improved liver histology and
virological and biochemical endpoints in comparison with lamivudine. Patients
who received at least 3 years of cumulative entecavir therapy in phase 3
studies and a long-term rollover study and underwent long-term liver biopsy
were evaluated for improvements in histological appearance. Sixty-nine
patients [50 HBeAg-positive and 19 HBeAg-negative] receiving entecavir therapy
underwent long-term liver biopsy (median time of biopsy = 6 years, range = 3-7
years). Histological improvement was analyzed for 57 patients who had adequate
baseline biopsy samples, baseline Knodell necroinflammatory scores >/=2, and
adequate long-term biopsy samples. At the time of long-term biopsy, all
patients in the cohort had a hepatitis B virus DNA level <300 copies/mL, and
86% had a normalized alanine aminotransferase level. Histological improvement
(>/=2-point decrease in the Knodell necroinflammatory score and no worsening
of the Knodell fibrosis score) was observed in 96% of patients, and a
>/=1-point improvement in the Ishak fibrosis score was found in 88% of
patients, including all 10 patients with advanced fibrosis or cirrhosis at the
phase 3 baseline. Conclusion: The majority of nucleoside-naive patients with
CHB who were treated with entecavir in this long-term cohort achieved
substantial histological improvement and regression of fibrosis or cirrhosis.

(HEPATOLOGY 2010).
PMID: 20683932

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