Current Hepatitis Reports

, Volume 11, Issue 2, pp 90–94

Partial Response to Entecavir and Tenofovir in Naïve Patients with Chronic Hepatitis B: Clinical Relevance and Management

Authors

    • 1st Division of Gastroenterology, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore PoliclinicoUniversità di Milano
  • Mauro Viganò
    • Hepatology Unit, Ospedale San GiuseppeUniversità degli Studi di Milano
  • Massimo Colombo
    • 1st Division of Gastroenterology, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore PoliclinicoUniversità di Milano
Hepatitis B: Therapeutics (P Martin, Section Editor)

DOI: 10.1007/s11901-012-0127-5

Cite this article as:
Lampertico, P., Viganò, M. & Colombo, M. Curr Hepatitis Rep (2012) 11: 90. doi:10.1007/s11901-012-0127-5

Abstract

Entecavir and tenofovir are the currently recommended first line analogues for treatment of naïve 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.

Keywords

HBV infectionChronic hepatitisAntiviral treatmentEntecavirTenofovirDrug resistanceRescue therapyAdd-on strategyLong-term treatmentClinical resistance

Copyright information

© Springer Science+Business Media, LLC 2012