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Viral suppression in HBeAg-positive chronic hepatitis B patients with high HBV DNA

Tenofovir is superior to entecavir for achieving complete viral suppression in HBeAg-positive chronic hepatitis B patients with high HBV DNA, reports the latest issue of the Alimentary Pharmacology & Therapeutics.

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Entecavir and tenofovir disoproxil fumarate are the two first-line anti-viral therapies for chronic hepatitis B (CHB).

However, there are limited studies directly comparing their effectiveness.

Dr Nguyen and colleagues from California, USA compared the effectiveness of entecavir and tenofovir in nucleos(t)ide-naïve CHB patients with high hepatitis B virus (HBV) DNA levels, defined as serum HBV DNA greater than 6 log10 IU/mL.

The research team performed a retrospective multicentre cohort study of adult CHB patients who were seen between 2009 and 2012 at 4 Northern California community gastroenterology and hepatology clinics.

The team identified 59 consecutive patients treated with tenofovir and 216 patients treated with entecavir.

Complete suppression was 18% at 6 months with TDF
Alimentary Pharmacology & Therapeutics

Pre-treatment characteristics were similar between the 2 groups.

Among HBeAg-negative patients, there was no significant difference in viral suppression rates between entecavir and tenofovir.

In contrast, among HBeAg-positive patients, those treated with tenofovir achieved viral suppression significantly more rapidly than those treated with entecavir.

The Kaplan–Meier estimated probability of complete suppression was 18% vs. 11% at 6 months, 51% vs. 28% at 12 months and 72% vs 39% at 18 months, with tenofovir and entecavir, respectively.

Multivariate Cox proportional hazards analysis indicated that treatment with tenofovir compared to entecavir was a significant predictor of viral suppression, but only for HBeAg-positive patients.

Dr Nguyen's team concludes, "Tenofovir is significantly more effective than entecavir for achieving complete viral suppression in HBeAg-positive, nucleos(t)ide-naïve chronic hepatitis B patients with HBV DNA greater than 6 log10 IU/mL."

Aliment Pharmacol Ther 2014: 39(6): 629–637
05 March 2014

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