Abstract
Entecavir and tenofovir are the currently recommended first line analogues for treatment of naive patients with chronic hepatitis B. Despite their overall efficacy and high genetic barrier granting for a low risk of resistance, both regimens will fail to completely suppress HBV DNA at week 48 in 10% of HBeAg-negative and 30% of HBeAg-positive patients. A pre-treatment level >8 log10 IU/mL HBV DNA and poor medication adherence were the most significant predictors of a partial virological response (PVR). While the clinical relevance of PVR is still poorly understood, nucleos(t)ide (NUC)-naive PVR patients who maintained detectable levels of viremia in follow up, were at risk of developing resistance to ETV. Patients with a suboptimal decline of viremia during the first 48 weeks of therapy with ETV and/or a residual viremia >1,000 IU/mL, can be protected by a rescue switch to TDF. Resistance to TDF has not been described so far, yet the long-term risk of PVR in TDF-treated patients remains unclear.
| Original language | English |
|---|---|
| Pages (from-to) | 90-94 |
| Number of pages | 5 |
| Journal | Current Hepatitis Reports |
| Volume | 11 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Jun 2012 |
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Keywords
- Add-on strategy
- Antiviral treatment
- Chronic hepatitis
- Clinical resistance
- Drug resistance
- Entecavir
- HBVinfection
- Long-term treatment
- Rescue therapy
- Tenofovir
ASJC Scopus subject areas
- Hepatology
- Virology
Cite this
Partial response to entecavir and tenofovir in naïve patients with chronic hepatitis B : Clinical relevance and management. / Lampertico, Pietro; Viganò, Mauro; Colombo, Massimo.
In: Current Hepatitis Reports, Vol. 11, No. 2, 06.2012, p. 90-94.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Partial response to entecavir and tenofovir in naïve patients with chronic hepatitis B
T2 - Clinical relevance and management
AU - Lampertico, Pietro
AU - Viganò, Mauro
AU - Colombo, Massimo
PY - 2012/6
Y1 - 2012/6
N2 - Entecavir and tenofovir are the currently recommended first line analogues for treatment of naive patients with chronic hepatitis B. Despite their overall efficacy and high genetic barrier granting for a low risk of resistance, both regimens will fail to completely suppress HBV DNA at week 48 in 10% of HBeAg-negative and 30% of HBeAg-positive patients. A pre-treatment level >8 log10 IU/mL HBV DNA and poor medication adherence were the most significant predictors of a partial virological response (PVR). While the clinical relevance of PVR is still poorly understood, nucleos(t)ide (NUC)-naive PVR patients who maintained detectable levels of viremia in follow up, were at risk of developing resistance to ETV. Patients with a suboptimal decline of viremia during the first 48 weeks of therapy with ETV and/or a residual viremia >1,000 IU/mL, can be protected by a rescue switch to TDF. Resistance to TDF has not been described so far, yet the long-term risk of PVR in TDF-treated patients remains unclear.
AB - Entecavir and tenofovir are the currently recommended first line analogues for treatment of naive patients with chronic hepatitis B. Despite their overall efficacy and high genetic barrier granting for a low risk of resistance, both regimens will fail to completely suppress HBV DNA at week 48 in 10% of HBeAg-negative and 30% of HBeAg-positive patients. A pre-treatment level >8 log10 IU/mL HBV DNA and poor medication adherence were the most significant predictors of a partial virological response (PVR). While the clinical relevance of PVR is still poorly understood, nucleos(t)ide (NUC)-naive PVR patients who maintained detectable levels of viremia in follow up, were at risk of developing resistance to ETV. Patients with a suboptimal decline of viremia during the first 48 weeks of therapy with ETV and/or a residual viremia >1,000 IU/mL, can be protected by a rescue switch to TDF. Resistance to TDF has not been described so far, yet the long-term risk of PVR in TDF-treated patients remains unclear.
KW - Add-on strategy
KW - Antiviral treatment
KW - Chronic hepatitis
KW - Clinical resistance
KW - Drug resistance
KW - Entecavir
KW - HBVinfection
KW - Long-term treatment
KW - Rescue therapy
KW - Tenofovir
UR - http://www.scopus.com/inward/record.url?scp=84865798344&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84865798344&partnerID=8YFLogxK
U2 - 10.1007/s11901-012-0127-5
DO - 10.1007/s11901-012-0127-5
M3 - Article
VL - 11
SP - 90
EP - 94
JO - Current Hepatitis Reports
JF - Current Hepatitis Reports
SN - 1540-3416
IS - 2
ER -