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Cited 12 time in webofscience Cited 14 time in scopus
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Switching to tenofovir vs continuing entecavir for hepatitis B virus with partial virologic response to entecavir: a randomized controlled trial

Authors
Yim, Hyung JoonKim, In HeeSuh, Sang JunJung, Young KulKim, Ji HoonSeo, Yeon SeokYeon, Jong EunKim, C. W.Kwon, S. Y.Park, S. H.Lee, M. S.Um, Soon HoByun, Kwan Soo
Issue Date
Nov-2018
Publisher
Blackwell Publishing Inc.
Keywords
chronic hepatitis B; entecavir; partial virologic response; tenofovir; treatment
Citation
Journal of Viral Hepatitis, v.25, no.11, pp.1321 - 1330
Indexed
SCIE
SCOPUS
Journal Title
Journal of Viral Hepatitis
Volume
25
Number
11
Start Page
1321
End Page
1330
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/2960
DOI
10.1111/jvh.12934
ISSN
1352-0504
Abstract
Entecavir 0.5mg (ETV) is widely used among treatment-naive chronic hepatitis B (CHB) patients. However, 10%-30% of patients show partial virologic response (PVR) to the drug. If the hepatitis B virus (HBV) continues to replicate, the underlying liver disease may progress. Herein, we compared the efficacy of switching to tenofovir disoproxil fumarate (TDF) with that of continuing ETV in CHB patients with PVR to ETV. This was an open-label randomized controlled trial including CHB patients who had been receiving 0.5mg of ETV for >12months, but who still had detectable HBV DNA levels of >60IU/mL without known resistance to ETV. Sixty patients were enrolled and 45 qualified for the study: Twenty-two patients were randomly assigned into the TDF group and 23 into the ETV group. After 12months of treatment, the virologic response rate (HBV DNA <20IU/mL) was significantly higher in the TDF group than in the ETV group, as measured using per-protocol analysis (55% vs 20%; P=.022) and intention-to-treat analysis (50% vs 17.4%; P=.020). The reduction in HBV DNA was greater (-1.13 vs -0.67 log(10) IU/mL; P=.024), and the mean HBV DNA level was lower (1.54 vs 2.01 log(10) IU/mL; P=.011) in the TDF group than in the ETV group. In conclusion, to achieve optimal response in CHB patients with PVR to ETV, switching to TDF would be a better strategy than continuing ETV. Appropriate modification of therapy would further improve the outcome of chronic HBV infection.
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Byun, Kwan Soo
Guro Hospital (Department of Gastroenterology and Hepatology, Guro Hospital)
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