Resultados en la práctica clínica del tratamiento de la hepatitis crónica por virus B con tenofovir y entecavir

Abstract

The current first line treatment for chronic hepatitis B virus is with entecavir andtenofovir. However, there are few data regarding the results obtained from these treatmentsin clinical practice. Objective: To assess viral response and safety of treatment with entecavir and tenofovir in a5-year follow-up. Material and methods: Observational study on patients with chronic hepatitis B virus who begantreatment with tenofovir or entecavir between January 2008 and December 2012. Results: Seventy patients were included; 42 (60%) were treated with entecavir and 28 (40%)with tenofovir. Of these, 75.7% were men, with an average age of 53 (SD ± 14) years, and mostwere white (70%). A liver biopsy was performed on 46 patients (F0 8.7%; F1 6.5%; F2 26.1%;F3 43.5% and F4 15.2%). Of all the patients, 51.4% were treatment naive, and of the groupof previously treated patients, 17.6% had received interferon; 26.4% had received interferonfollowed by one or more analogues; and 55.8% had received other nucleoside or nucleotideanalogues.The time of follow-up was 36 (SD ± 12) months. The average initial DNA was 31,570,006UI/mL (range 24-1,100,000,000 UI/mL). All except 3 presented undetectable DNA after oneyear of treatment. Ten patients were HBeAg-positive at the beginning of the treatment and 2seroconverted. At the beginning of the treatment, creatinine was 0.9 (SD ± 0.3) mg/dL and theestimated glomerular filtration rate (eGFR) was 93.92 ml/min/1.73 m2(DE 21.92); both keepingstable after a year of treatment (creatinine levels 0.93 SD ± 0.27 mg/dL, eGFR 91.7392 SD± 21.38 ml/min/1.73 m2). Conclusions: Entecavir and tenofovir are safe and effective in clinical practice for the treatmentof chronic hepatitis B virus, both in treatment-naive patients and in those previously treated.