Korean J Hepatol > Volume 16(1); 2010 > Article
The Korean Journal of Hepatology 2010;16(1): 57-65.
doi: https://doi.org/10.3350/kjhep.2010.16.1.57
Efficacy and predictors of the virologic response to entecavir therapy in nucleoside naive patients with chronic hepatitis B
Hyung-Joon Myung, M.D., Sook-Hyang Jeong, M.D., Jin-Wook Kim, M.D., Hee-Sup Kim, M.D., Je-Hyuck Jang, M.D., Dong Ho Lee, M.D., Nayoung Kim, M.D., Jin-Hyeok Hwang, M.D., Young Soo Park, M.D., Sang-Hyub Lee, M.D.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea, Seoul National University Bundang Hospital, Seongnam, Korea.
The aim of this study was to elucidate the antiviral efficacy and the predictors of entecavir treatment in nucleoside-naive chronic hepatitis B patients. Methods: A total of 160 patients treated with entecavir (0.5 mg daily) for at least 24 weeks were consecutively enrolled. The virologic response (HBV DNA<2,000 copies/mL), biochemical response (ALT≤ upper limit of normal), and virologic breakthrough (>1 log10 copies/mL increase in HBV DNA level above nadir on two consecutive occasions) were retrospectively analyzed. Results: The mean follow-up duration was 58.8 weeks, and 85 patients (53.1%) showed HBeAg positivity. The median pretreatment levels of serum ALT and HBV DNA were 99 IU/L and 7.6 log10 copies/mL, respectively. The cumulative rates at 12, 24, 48, and 72 weeks were 37.5%, 68.1%, 87.4%, and 95.8%, respectively, for the virologic response; 40.0%, 66.2%, 84.5%, and 92.7% for the biochemical response; 10.6%, 18.8%, 27.0%, and 34.5% for HBeAg loss; and 3.5%, 7.1%, 9.0%, and 13.2% for HBeAg seroconversion. There was no case of virologic breakthrough. An absence of HBeAg and a low serum HBV DNA level (<8 log10 copies/mL) at baseline were significant predictors of the virologic response in a multivariate analysis (P<0.01). Conclusions: Entecavir therapy showed excellent efficacy in nucleoside-na?ve chronic hepatitis B patients. The predictors of a virologic response were an absence of HBeAg and a low baseline HBV DNA level. (Korean J Hepatol 2010;16:57-65)
KeyWords: Hepatitis B virus; Entecavir; Hepatitis B chronic; Treatment efficacy; Drug resistance

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