Prolonged use of tenofovir and entecavir in hepatitis B virus-related cirrhosis.

Abstract

Limited data is available from India on outcome and efficacy of tenofovir and entecavir in hepatitis B virus (HBV)-related cirrhosis when used for prolonged time. We report the long-term efficacy and outcome of these antiviral drugs in patients with chronic HBV infection, with compensated or decompensated cirrhosis. We retrospectively analyzed laboratory and clinical data of 400 HBV-related cirrhotic patients without access to liver transplantation, who were treated with tenofovir/entecavir therapy, from January 2007 to January 2014. Two hundred and ten (52.5%) patients had at least one of the components of decompensation at baseline. Two hundred and twenty (55%) and 180 (45%) patients were initiated tenofovir and entecavir, respectively. Follow up period was 45 (12-68) months for tenofovir and 36 (11-60) months for entecavir. At the end of 1year, levels of HBV DNA <20IU/mL were achieved in 91.8 % and 88.8% of patients, and alanine aminotransferase normalized in 54.5 % and 55.5% of patients who received tenofovir and entecavir, respectively. At the last visit, Child-Turcotte-Pugh scores improved among 29.5% of patients who received tenofovir, 25% of those who received entecavir, and remained stable in 61.9 % and 65% patients, respectively, in both groups. The 5-year cumulative rate of liver decompensation, hepatocellular carcinoma, and cirrhosis-related complications were 3.1 %, 1.9 %, and 2.1% with an annual incidence of 0.8 %, 0.3 %, and 0.5% per person-year, respectively. Tenofovir and entecavir were effective and potent drugs for prolonged treatment of HBV cirrhosis and improved the overall clinical course.