Lamivudine and Entecavir for Acute Hepatitis B: A Systematic Review and Meta-Analysis

Abstract

Background. Acute hepatitis B infection is associated with severe liver disease and chronic sequelae in some cases. The purpose of this review was to determine the efficacy of nucleoside analogues (NA) (lamivudine versus entecavir) compared to placebo or no intervention for treating acute primary HBV infection. Methods. A meta-analysis for drug intervention was performed, following a fixed-effect model. Randomized controlled trials (RCTs) and quasi-randomized studies that evaluated the outcomes of NA in acute hepatitis B infection were included. The following outcomes were considered: virological cure (PCR negative), elimination of acute infection (seroconversion of HBsAg), mortality, and serious adverse events. Results. Five trials with 627 adult participants with severe acute hepatitis B defined by biochemical and serologic parameters were included. Virological cure did not favor any intervention: OR 0.96, 95% CI 0.54 to 1.7 (p = 0.90), I2 = 58%. Seroconversion of HBsAg to negative favored placebo/standard-of-care compared to lamivudine: OR 0.54, 95% CI 0.33 to 0.9 (p = 0.02), I2 = 31%. The only trial that compared entecavir and lamivudine favored entecavir over lamivudine (OR: 3.64, 95% CI 1.31–10.13; 90 participants). Adverse events were mild. Conclusion. There is insufficient evidence that NA obtain superior efficacy compared with placebo/standard-of-care in patients with acute viral hepatitis, based on low quality evidence.

Juveniles, young adults, and infants with hepatitis B virus infection: A genomic study

“…Given the negative findings for intrahepatic HBsAg (immunohistochemical staining) and HBV integration, the clinical significance of antiviral treatment for juveniles and young adults with acute HBV infection requires further elucidation. 15 F I G U R E 3 Serum HBsAg quantifications and HBV DNA levels of the included infant patients at biopsy. HBsAg, hepatitis B surface antigen; HBV, hepatitis B virus.…”

“…In this study, all patients were treatment‐naïve at biopsy. Given the negative findings for intrahepatic HBsAg (immunohistochemical staining) and HBV integration, the clinical significance of antiviral treatment for juveniles and young adults with acute HBV infection requires further elucidation 15 …”

Entecavir induced gynecomastia- Triggering factor or coincidence?

“…It began to be widely used all over the world after it was approved by the US Food and Drug Administration in 2005. 8 The case of gynecomastia due to entecavir use has been reported very rarely in the literature. In the literature, the development of gynecomastia was first reported in a 55-year-old male patient using entecavir by Bayramıçlı et al 9 As a result, patients treated with various agents during hepatitis B treatment should be closely monitored for treatment response and, of course, treatment side effects.…”

Exploring theophylline-1,2,4-triazole tethered N-phenylacetamide derivatives as antimicrobial agents: unraveling mechanisms via structure-activity relationship, in vitro validation, and in silico insights

“…Due to their substantial applications across industries, including biological, agricultural, medicinal and pharmacological fields, chemists have drawn their attention to various heterocyclic scaffolds, such as piperazines (Halimehjani et al, 2022), benzoxazole, benzothiazole (Zou et al, 2023), heterocyclic sulfonamides (Apiraksattayakul et al, 2022), benzofurans (Farhat et al, 2022), benzimidazoles (Nardi et al, 2023), thiadiazoles (Janowska et al, 2020), pyarzoles (Nazeer et al, 2023), lamivudines (Henriquez-Camacho et al, 2023), ciprofloxacin-based acetanilides (Zhang et al, 2018), triazoles (Irfan et al, 2024), quinoxalines (Montana et al, 2019), and oxadiazoles (Kerru et al, 2020;Irfan et al, 2022;Irfan et al, 2023). Notably, theophylline (Shahzadi et al, 2020;Shahzadi et al, 2022a), a naturally occurring methylxanthine, has found frequent therapeutic use in treating conditions such as asthma, respiratory deficits in premature infants, and chronic pulmonary obstructive disease (COPD).…”