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PLoS One. 2015;10(6):e0130392.

Comparison of the Efficacy of Entecavir and Tenofovir in Nucleos(T)ide Analogue-Experienced Chronic Hepatitis B Patients.

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제1저자 조은주 · 교신저자 이정훈

소속 (2)
  1. Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
  2. Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.

Abstract

The efficacy of entecavir (ETV) and tenofovir (TDF) for the treatment of nucleos(t)ide analogue (NA)-experienced chronic hepatitis B (CHB) patients has been little studied. Here, we compare the efficacy of both ETV and TDF in NA-experienced CHB patients without detectable genotypic resistance. This retrospective cohort study included consecutive NA-experienced patients who had neither current nor previous genotypic resistance and had received ETV or TDF for at least 6 months. Overall, 202 patients (146 patients in the ETV group and 56 in the TDF group) were analyzed. The cumulative probabilities of complete virologic suppression (CVS) at month 12 were 76.1% in the ETV group and 95.0% in the TDF group (P<0.001), respectively. The TDF-treated group achieved CVS more rapidly than the ETV group for both Hepatitis B e antigen (HBeAg)-negative and -positive patients (P = 0.006 and < 0.001, respectively), and for those with both low (< 2,000 IU/mL) and high (≥ 2,000 IU/mL) HBV DNA levels (P = 0.01 and 0.002, respectively). TDF group had an increased probability of achieving CVS (hazard ratio, 2.242; 95% confidence interval, 1.587-3.165; P = 0.001), after adjustment for HBV DNA level, the presence of HBeAg, and a history of CVS during prior treatment. During the treatment period, 23 patients (15.8%) in the ETV group developed virologic breakthrough, compared to none in the TDF group. The cumulative probabilities of developing virologic breakthrough and ETV-resistance at month 24 were 9.7% and 5.3%, respectively. In conclusion, TDF is preferable to ETV for achieving CVS in NA-experienced CHB patients without genotypic resistance.

Figures

Fig 1
Fig 1 Cumulative probabilities of complete virologic suppression and virologic breakthrough by treatment group. (A) Cumulative probabilities of complete virologic suppression (defined as HBV DNA level <20 IU/mL) during the treatment period are shown for each group. (B) Cumulative probabilities of virologic breakthrough (defined as an increase in HBV DNA level >1 log10 IU/mL) during the treatment period, are shown for each group. TDF, tenofovir disoproxil fumarate; ETV, entecavir.

그림 출처: PubMed Central 공개 논문 (PMC4488001)

Conflict of interest statement

Competing Interests:The authors have declared that no competing interests exist.

그 밖의 정보
출판 형태
Comparative Study, Journal Article, Research Support, Non-U.S. Gov't
저널
PloS one · eISSN 1932-6203
전자 출판
2015-06-29
MeSH
Adult · Antiviral Agents / therapeutic use · Cohort Studies · DNA, Viral / genetics · Drug Resistance, Viral / genetics · Female · Genotype · Guanine / analogs & derivatives / therapeutic use · Hepatitis B e Antigens / chemistry · Hepatitis B virus · Hepatitis B, Chronic / drug therapy · Humans · Male · Middle Aged · Multivariate Analysis · Nucleotides / therapeutic use · Probability · Retrospective Studies · Tenofovir / therapeutic use · Time Factors · Treatment Outcome
Substances
Antiviral Agents · DNA, Viral · Hepatitis B e Antigens · Nucleotides · entecavir · Guanine · Tenofovir
참고문헌
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