Tenofovir is superior to entecavir for achieving complete viral suppression in hbeag-positive chronic hepatitis b patients with high hbv dna
BACKGROUND: Entecavir (ETV) and tenofovir disoproxil fumarate (TDF) are the two first-line antiviral therapies for chronic hepatitis B (CHB); however, there are limited studies directly comparing their effectiveness. AIMS: To compare the effectiveness of ETV and TDF in nucleos(t)-ide-naïve CHB patie...
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| Glavni autori: | , , , |
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| Format: | Artigo |
| Jezik: | Inglês |
| Izdano: |
2014
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| Teme: | |
| Online pristup: | https://ncbi.nlm.nih.gov/pmc/articles/PMC3999385/ https://ncbi.nlm.nih.gov/pubmed/24467455 https://ncbi.nlm.nih.govhttp://dx.doi.org/10.1111/apt.12629 |
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| Samenvatting: | BACKGROUND: Entecavir (ETV) and tenofovir disoproxil fumarate (TDF) are the two first-line antiviral therapies for chronic hepatitis B (CHB); however, there are limited studies directly comparing their effectiveness. AIMS: To compare the effectiveness of ETV and TDF in nucleos(t)-ide-naïve CHB patients with high hepatitis B virus (HBV) DNA levels, defined as serum HBV DNA greater than 6 log(10) IU mL(−1). METHODS: We performed a retrospective multicenter cohort study of adult CHB patients who were seen between 2009 and 2012 at four Northern California community gastroenterology and hepatology clinics. RESULTS: We identified 59 consecutive patients treated with TDF and 216 patients treated with ETV. Pretreatment characteristics were similar between the two groups. Among HBeAg-negative patients, there was no significant difference in viral suppression rates between ETV and TDF (p = 0.72). In contrast, among HBeAg-positive patients, those treated with TDF achieved viral suppression significantly more rapidly than those treated with ETV (p < 0.0001); the Kaplan-Meier estimated probability of complete suppression was 18% vs. 11% at 6 months, 51% vs. 28% at 12 months, and 72% vs. 39% at 18 months, respectively. Multivariate Cox proportional hazards analysis indicated that treatment with TDF compared to ETV was a significant predictor of viral suppression but only for HBeAg-positive patients (HR = 2.59; 95% CI 1.58–4.22; p < 0.001). CONCLUSIONS: TDF is significantly more effective than ETV for achieving complete viral suppression in HBeAg-positive, nucleos(t)-ide-naïve chronic hepatitis B patients with HBV DNA greater than 6 log(10) IU mL(−1). |
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