Long-Term Treatment With Entecavir Induces Reversal of Advanced Fibrosis or Cirrhosis in Patients With Chronic Hepatitis B

Section: Discussionmentioning

confidence: 99%

Changes in liver stiffness and its associated factors during oral antiviral therapy in Chinese patients with chronic hepatitis B

Jin

Zhang

et al. 2017

“…Long-term ETV treatment (>3 years) attenuated necroinflammatory activity in all patients and reduced liver fibrosis in 57-100% of patients (1,14). Furthermore, advanced liver fibrosis was shown to be reversed after long-term antiviral treatment (14,15). However, these previous studies always included patients with long-term antiviral treatment of at least >1 year.…”

Section: Discussionmentioning

confidence: 89%

“…For instance, liver fibrosis has been reported to improve in 35-38% of lamivudine-treated CHB patients and 36-39% of ETV-treated CHB patients after one year (12,13). Long-term ETV treatment (>3 years) attenuated necroinflammatory activity in all patients and reduced liver fibrosis in 57-100% of patients (1,14). Furthermore, advanced liver fibrosis was shown to be reversed after long-term antiviral treatment (14,15).…”

Section: Discussionmentioning

confidence: 95%

Chronic hepatitis B patients with high liver fibrosis levels should receive antiviral treatment

Jin

et al. 2017

Abstract. The present study aimed to evaluate improvements in liver stiffness (LS) measured by transient elastography (TE) and associated factors in Chinese patients with chronic hepatitis B (CHB) treated with entecavir (ETV). A total of 190 consecutive CHB patients who received entecavir therapy and two LS measurements (LSMs) were enrolled in this retrospective study (average age, 47 years; 137 males [72.1%]), including 111 patients without liver cirrhosis (group 0) and 79 patients with liver cirrhosis (group 1). Each patient received LSM twice with an interval of six months. Normalized aspartate aminotransferase (AST) levels were accompanied by a significant reduction in LSM values (P<0.001) in each group. Multivariate analysis revealed that a higher initial LS value in groups 0 and 1, and a higher prothrombin time activity in group 1 was associated with a greater decline of the LS value. Higher initial quantitative hepatitis B surface antigen (qHBsAg) levels were correlated with a greater decline of the qHBsAg value in the two groups. In conclusion, LS values in CHB patients significantly improved after 24 weeks of entecavir therapy. The results suggested that higher LSM values at baseline contributed to a greater regression of LSM, and higher initial qHBsAg values could lead to greater qHBsAg reduction during ETV therapy. Extrapolating our results, we might be able to consider CHB patients who have higher initial LSM values or have higher levels of qHBsAg values when enrolled would have more benefit during ETV treatment.

“…The seroclearance of HBeAg and HBV DNA are critical indicators of progression in chronic HBV infection (26). A previous clinical study reported that 6 years of cumulative entecavir therapy resulted in improvements in liver histology and Ishak fibrosis scores (27). A prospective study also demonstrated that entecavir therapy resulted in an HBV DNA level of <500 copies/ml in 88% of compensated and 93% of decompensated cirrhosis cases (25).…”

Section: Discussionmentioning

confidence: 92%

Effect of entecavir in the treatment of patients with hepatitis B virus-related compensated and decompensated cirrhosis

Gai

Wang

2017

Abstract. Chronic hepatitis B virus (CHB) infection is a burden on global healthcare and is associated with a higher risk of serious sequelae, including cirrhosis and hepatocellular carcinoma. The clinical application of entecavir as a treatment for CHB has produced positive outcomes, and so is an attractive form of pharmacological therapy. However, little data exists comparing the safety and efficacy of entecavir for the treatment of hepatitis B virus (HBV)-related compensated, and decompensated cirrhosis, respectively. The aim of the present study was to evaluate entecavir therapy as a treatment for patients with HBV-related compensated and decompensated cirrhosis. A retrospective analysis of 46 compensated patients (compensated group) and 51 decompensated cirrhotic patients (decompensated group) treated with entecavir was conducted. Baseline demographics, clinical outcomes, and adverse events during the treatment were compared. Treatment with entecavir for 96 weeks resulted in significant improvements in serum levels of HBV DNA (P=0.002), albumin (P=0.014), cholinesterase (CHE; P=0.001), HBV DNA negativity rate (P=0.004), Child-Turcotte-Pugh score (P=0.030), alanine aminotransferase normalized rate (P=0.039), and the degree of esophageal varices liver stiffness (P=0.002) in the two groups. However, statistical analysis revealed that the improvements were significantly higher in the compensated group compared with the decompensated group (P<0.05). The complement component (C)3 and C4 levels were also significantly increased in the compensated group compared with the decompensated group at weeks 24, 48 and 96 (P<0.05). In addition, the incidences of hepatocellular carcinoma, upper digestive tract hemorrhage and ascites were significantly higher in the decompensated group compared with the compensated group (P<0.05). In conclusion, treatment with 96-week entecavir therapy produced similar clinical outcomes in compensated and decompensated cirrhotic patients via inhibiting HBV-DNA viral load and recovering complement C3 and C4; however, entecavir exerts a better effect on patients with compensated cirrhosis, and so this therapy may improve the prognosis of such patients.