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 |
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Pages (from-to) | 90-94 |
Number of pages | 5 |
Journal | Current Hepatitis Reports |
Volume | 11 |
Issue number | 2 |
DOIs | |
Publication status | Published - Jun 2012 |
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