Abstract
The introduction of nucleos(t)ide analogues for the treatment of chronic hepatitis B virus (HBV) infection was transformative in reducing morbidity and mortality. Entecavir, a potent selective nucleoside analogue first approved in 2005 for treatment of chronic HBV, is associated with significant antiviral, biochemical, serologic, and histologic responses. Rapid reductions in HBV DNA levels, low risk of resistance development, and a favorable adverse event profile have contributed to its clinical usefulness. Re-cent developments in the use of entecavir have increased its utility in the management of difficult-to-treat patients with chronic HBV, including those patients with decompensated liver disease. Recent studies in this population have demonstrated that entecavir 1.0 mg/d given for up to 48 weeks had superior antiviral activity when compared with adefovir and was generally safe and well tolerated. Long-term outcomes of entecavir in difficult-to-treat populations are eagerly anticipated.
Highlights
Chronic hepatitis B virus (HBV) infection affects 350 to 400 million individuals worldwide and 1.25 million in
The introduction of nucleos(t)ide analogues for the treatment of chronic hepatitis B virus (HBV) infection was transformative in reducing morbidity and mortality
Because entecavir treatment results in rapid reductions in HBV DNA levels and is associated with low long-term rates of resistance, the agent was investigated and later approved for treatment of patients with HBV with decompensated liver disease based on a randomized open-label study comparing entecavir with adefovir (Hepsera®; Gilead Sciences, Inc., Foster City, CA) [21,22]
Summary
Chronic hepatitis B virus (HBV) infection affects 350 to 400 million individuals worldwide and 1.25 million in. Chronic HBV infection is associated with an annual progression rate to cirrhosis of 2% to 5.5%, and there is a 5-year cumulative rate of progression of 8% to 20% in HBeAg-positive patients and 8% to 10% in HBeAg-negative patients [7]. Because entecavir treatment results in rapid reductions in HBV DNA levels and is associated with low long-term rates of resistance, the agent was investigated and later approved for treatment of patients with HBV with decompensated liver disease based on a randomized open-label study comparing entecavir with adefovir (Hepsera®; Gilead Sciences, Inc., Foster City, CA) [21,22]
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