Real life adherence of chronic hepatitis B patients to entecavir treatment

Abstract

BackgroundReal-life prospective data on adherence to nucleos(t)ide analogues in chronic hepatitis B patients are scarce. AimsWe investigated adherence to entecavir in relation to virological response. MethodsIn this prospective study, we provided 100 consecutive chronic hepatitis B patients with a medication dispenser that monitored entecavir intake during 16 weeks therapy. Hepatitis B virus (HBV) DNA was measured at baseline and after 16 weeks. Beliefs about medicines were evaluated using a questionnaire. ResultsAdherence over 16 weeks averaged 85±17%, with 70% of patients exhibiting good (i.e. ≥80%) adherence. Patients with poor (i.e. <80%) adherence were significantly younger (p=0.01), with more often indifferent attitudes towards entecavir (p=0.03) Viral breakthrough did not occur during the study. Adherence in patients with HBV DNA after 16 weeks >20IU/mL (n=18) and ≤20IU/mL (n=81) averaged 83% and 91% respectively (p=0.19). In multivariate analysis, adherence was not a significant predictor of HBV DNA negativity (adjusted OR 1.02; p=0.34), after adjustment for duration of entecavir treatment (p<0.001) and HBe-status (p=0.001). Conclusions70% of chronic hepatitis B patients exhibited good adherence to entecavir, with younger age and an indifferent attitude being risk factors for poor adherence. Poor adherence was not an independent predictor of virological response.