Efficacy of entecavir and tenofovir in chronic hepatitis B under treatment in the public health system in southern Brazil

Pereira, Camila V; Tovo, Cristiane Valle; Grossmann, Thiago Kreutz; Mirenda, Henrique; Dal-Pupo, Bruna B; Almeida, Paulo Roberto Lerias de; Mattos, Ângelo Alves de

doi:10.1590/0074-02760150390

Cited by 8 publications

(7 citation statements)

References 34 publications

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“…In North America, Morris and his colleagues from Toronto-Canada, found in his study of (HBeAg)-positive, Lamivudine refractory patients that switching to Entecavir was superior to continued Lamivudine at week 48 it regards to histological improvement, viral load reduction, and ALT normalization [24]. Results from South America are also comparable to our data regarding efficacy and safety of entecavir [25,26]. However, a similar but smaller study from Morocco, North Africa showed only 85% viral response in 48 weeks follow up of 41 patients on Entecavir therapy [27].…”

Section: Discussionsupporting

confidence: 85%

Retrospective-Prospective Study on Efficacy & Safety of Entecavir in Chronic Hepatitis B West Asian Patients with Genotype D

Akrouf¹,

Gad²,

Ibraheem³

et al. 2017

J Clin Infect Dis Pract

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Aim: To assess the long term efficacy and safety of Entecavir in the treatment of CHB in Asian-Arabic patients with genotype D, for both nucleoside-naïve as well as experienced, comparing HBeAg positive and negative group. Methods:This study included 70 CHB consecutive patients who were maintained on Entecavir for at least 36 months retrospectively and followed up prospectively every 3 months for a total of 18 months, at 2 centers in Kuwait (October 2012 and April 2014).Results: It showed that 23 (32.8%) were HBeAg +ve. All were found to be HBV genotype D, 47.1% naive, 22 (31.4%) females, with a mean age of 42.9 ± (13), 14 (20%) cirrhotic and 1(1.4%) decompensated. There were no significant differences in the pre-treatment HBV-DNA level among HBeAg+ve and HBeAg-ve group, with a mean± SD log 10 of 7.9 ± 5.4 and 7.4 ± 5.0 respectively (P=0.237). There was a significant viral load reduction in both groups after 6 months of treatment with Entecavir. The reduction was more pronounced in the HBeAg-ve compared to HBeAg +ve group. In HBeAg +ve, 19 patients (82.61%) had complete HBV-DNA suppression after a median period of 7 month, while in HBeAg -ve group; all (100%) had complete HBV-DNA suppression after a median period of 5 month duration (P<0.05). None showed primary non response to Entecavir in both groups. In the HBeAg-ve group; one (2.13%) had HBsAg loss at 45 month compared to non in HBeAg+ve group (P<0.001), while in the HBeAg+ve group; 5 (21.74%) showed HBeAg clearance after a median of 16 month during Entecavir treatment. Multivariate analysis identified HBeAg negative status, pre-treatment as the only independent factor affecting complete viral suppression on Entecavir treatment. The drug showed 100% safety, as there were no serious adverse events throughout 54 month of follow up. None showed hepatic decompensation, HCC or need for liver transplantation during follow up. Also, there was no reported death throughout study period in both groups. Conclusions:In real life data; long term Entecavir treatment for up to 54 months in West Asian CHB patients, with genotype D suppressed HBV-DNA to an undetectable level in 100% of HBeAg-ve, compared to 82% in HBeAg +ve group. Entecavir is considered an effective and safe choice on long term use for treatment CHB patients.

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Section: Discussionsupporting

confidence: 85%

Retrospective-Prospective Study on Efficacy & Safety of Entecavir in Chronic Hepatitis B West Asian Patients with Genotype D

Akrouf¹,

Gad²,

Ibraheem³

et al. 2017

J Clin Infect Dis Pract

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“…Among these selected studies, 17 focused on the comparison of TDF vs. ETV, 5 focused on the comparison of TAF vs. TDF, and 6 focused on the comparison of TDF+ETV vs. TDF. Among these selected studies, 13 were RCTs, 15 – 27 14 were cohort studies, 28 – 41 and only 1 was a cross-sectional study 42 ( Table 1 ). Quality assessment suggested that all the cohort studies and RCTs possessed high quality ( Table 1 and Fig.…”

Section: Resultsmentioning

confidence: 99%

Tenofovir Alafenamide Fumarate, Tenofovir Disoproxil Fumarate and Entecavir: Which is the Most Effective Drug for Chronic Hepatitis B? A Systematic Review and Meta-analysis

Ma¹,

Liu²,

Wang³

et al. 2021

Journal of Clinical and Translational Hepatology

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Background and Aims The therapeutic effect of tenofovir alafenamide fumarate (TAF), tenofovir disoproxil fumarate (TDF) and entecavir (ETV) on chronic hepatitis B (CHB) patients remains inconsistent. The aim of this study was to explore the differences in virological responses to TAF, TDF and ETV in patients with CHB. Methods Literature searches were conducted of the PubMed, EMBASE, and the Cochrane Library databases to identify randomized controlled trials and observational studies published up to July 21, 2020. Statistical comparisons of virological response between TDF, ETV, and TAF were carried out with pooled odds ratio (OR) values. Results The virological response in TDF-treated CHB patients was notably superior to that of the ETV-treated CHB patients after 12-weeks [OR=1.12, 95% confidence interval (CI): 0.89–1.41], 24-weeks (OR=1.33, 95% CI: 1.11–1.61), 48-weeks (OR=1.62, 95% CI: 1.16–2.25), 72-weeks (OR=1.43, 95% CI: 0.78–2.62), and 96-weeks (OR=1.56, 95% CI: 0.87–2.81) treatment. No significant difference was observed for the virological responses in CHB patients after 48-weeks treatment with TAF or TDF. The virological response in TDF+ETV-treated CHB patients was superior to that of TDF-treated CHB patients after 24-weeks, 48-weeks (OR=1.54, 95% CI: 1.17–2.02), 96-weeks, and 144-weeks. Conclusions The virological response in TDF-treated CHB patients was superior to that in ETV-treated CHB patients, but there was no significant difference between TAF and TDF. In addition, the therapeutic effect of TDF+ETV was superior to TDF alone.

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“…This proportion increases to 100% in both groups at month 18. In other studies conducted in real clinical practice with chronic hepatitis B patients, overall viral load negativization rates at 12 months in patients treated with tenofovir ranged from 59.2 to 91.9% [ 24 , 25 , 47 , 49 – 51 ]; and with entecavir, from 41 to 89.4% [ 21 – 23 , 51 – 62 ]. These differences between the studies are possibly due to the diverse populations studied in each case, the different sensitivity of the PCR used to detect viral load, and to the fact that, in many studies, patients previously treated with other treatments for HBV are included.…”

Section: Discussionmentioning

confidence: 99%

Chronic hepatitis B genotype E in African migrants: response to nucleos(t)ide treatment in real clinical practice

et al. 2018

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BackgroundHepatitis B virus (HBV) genotype E is a poorly studied genotype that almost exclusively occurs in African people. It seems to harbour intrinsic potential oncogenic activity and virological characteristics of immune scape but a paucity of information is available on clinical and virological characteristic of HBV genotype E-infected patients as well as on the efficacy of anti-HBV drugs for such patients. The increasing flow of migrants from high endemic HBV sub-Saharan Africa, where genotype E is the predominant one, to Western countries makes improving such knowledge critical in order to deliver proper medical care.MethodsProspective observational study of naïve patients of sub-Saharan origin treated for chronic HBV genotype E infection at a Tropical Medicine clinic sited in Spain from February 2004 to January 2018. The aim of the study was to describe the response of chronic HBV genotype E infection to nucleos(t)ide analogues (NA), entecavir or tenofovir, in real clinical practice.ResultsDuring the study period, 2209 sub-Saharan patients were assisted at our Tropical Medicine Unit and 609 (27.6%) had chronic HBV (CHB) infection. Genotype information was available for 55 naïve patients initiating treatment with NA (entecavir or tenofovir), 43 (84.3%) of them being genotype E, although 15 were excluded because they did not meet study inclusion criteria. Thus, a total of 28 CHB genotype E patients were included and followed for 24 months at least. Twenty-one patients were in HBeAg-negative chronic hepatitis phase and 7 patients in HBeAg-positive chronic hepatitis phase. After one year of treatment, among those with good adherence, 89.4% (17/19) of the HBeAg-negative patients and 80% of the HBeAg-positive ones had undetectable viral loads. Response rates reached 100% in both groups after 15–18 months of follow-up. Out of the 7 HBeAg-positive patients, 6 (85.7%) presented HBeAg loss in a median time of 31.8 months. Neither serious adverse effects nor hepatocarcinoma cases happened during the study period.ConclusionsHBV genotype may influence disease progression and antiviral response. Our study provides precious information on the efficacy and safety of NA treatment for CHB genotype E infection, a fairly unknown genotype with and increasing epidemiological impact.

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Efficacy of entecavir and tenofovir in chronic hepatitis B under treatment in the public health system in southern Brazil

Cited by 8 publications

References 34 publications

Retrospective-Prospective Study on Efficacy & Safety of Entecavir in Chronic Hepatitis B West Asian Patients with Genotype D

Retrospective-Prospective Study on Efficacy & Safety of Entecavir in Chronic Hepatitis B West Asian Patients with Genotype D

Tenofovir Alafenamide Fumarate, Tenofovir Disoproxil Fumarate and Entecavir: Which is the Most Effective Drug for Chronic Hepatitis B? A Systematic Review and Meta-analysis

Chronic hepatitis B genotype E in African migrants: response to nucleos(t)ide treatment in real clinical practice

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