[Tenofovir and entecavir for chronic hepatitis B infection treatment: a single-center experience]

[Tenofovir and entecavir for chronic hepatitis B infection treatment: a single-center experience]

Authors

  • Fabio Tarsetti SOD Malattie dell’Apparato digerente, Endoscopia Digestiva e Malattie Infiammatorie Croniche Intestinali. Azienda Ospedaliera Universitaria “Ospedali Riuniti”, Ancona
  • Giuseppe Tarantino SOD Clinica di Gastroenterologia, Epatologia ed Endoscopia d’Urgenza, Azienda Ospedaliera Universitaria, “Ospedali Riuniti”, Ancona
  • Piergiorgio Mosca SOD Malattie dell’Apparato digerente, Endoscopia Digestiva e Malattie Infiammatorie Croniche Intestinali. Azienda Ospedaliera Universitaria “Ospedali Riuniti”, Ancona
  • Emidio Scarpellini SOD Malattie dell’Apparato digerente, Endoscopia Digestiva e Malattie Infiammatorie Croniche Intestinali. Azienda Ospedaliera Universitaria “Ospedali Riuniti”, Ancona
  • Giammarco Fava SOD Malattie dell’Apparato digerente, Endoscopia Digestiva e Malattie Infiammatorie Croniche Intestinali. Azienda Ospedaliera Universitaria “Ospedali Riuniti”, Ancona

DOI:

https://doi.org/10.7175/cmi.v9i4.1202

Keywords:

HBV, Entecavir, Tenofovir, Seroconversion

Abstract

BACKGROUND AND AIM: The current treatment of chronic hepatitis B infection (CHBV) has achieved several step-ups thanks to the introduction of the new-generation nucleos(t)ide analogs. Entecavir and tenofovir have shown a high genetic resistance barrier and a low rate of side effects. In literature, there are a few studies comparing entecavir and tenofovir in the treatment of CHBV. Thus, we describe the results of our experience in managing CHBV patients with tenofovir vs. entecavir.

MATERIALS AND METHODS: We have retrospectively evaluated, from 2007 to date, 20 CHBV patients treated with entecavir and tenofovir. All the patients underwent basal and periodical clinical follow-up, blood tests, virological tests, Fibroscan® test or liver biopsy and also upper abdominal ultrasound examination. Study endpoints were: viral replication inhibition, viral antigens seroconversion and transaminases normalization. Drug-associated side effects were also registered.

RESULTS: After 12 weeks of therapy, entecavir and tenofovir lead to HBV-DNA negativization in 44% and 62% of patients, respectively. A case of viral seroconversion for HBeAg and HBsAg was evident in entecavir group, while no cases were registered in tenofovir group. After 12 weeks, 11% of entecavir treated patients and 37% of tenofovir treated patients showed normalization of transaminases.

DISCUSSION: Tenofovir seems to exert a better viral replication inhibition (though not statistically significant) and to show transaminases improvement in comparison with entecavir, which, in turn, results more effective in HBeAg/HBsAg seroconversion. Both drugs have a high safety profile in terms of side effects.

[Article in Italian]

References

McMahon BJ. Epidemiology and natural history of hepatitis B. Semin Liver Dis 2005; 25: 3-8; http://dx.doi.org/10.1055/s-2005-915644

Fattovich G, Stroffolini T, Zagni I, et al. Hepatocellular carcinoma in cirrhosis: incidence and risk factors. Gastroenterology 2004; 127: 35-50; http://dx.doi.org/10.1053/j.gastro.2004.09.014

European Association For The Study Of The Liver. EASL clinical practice guidelines: Management of chronic hepatitis B virus infection. J Hepatol 2012; 57: 167-85; http://dx.doi.org/10.1016/j.jhep.2012.02.010

Tang CM, Yau TO, Yu J. Management of chronic hepatitis B infection: current treatment guidelines, challenges, and new developments. World J Gastroenterol 2014; 20: 6262-78; http://dx.doi.org/10.3748/wjg.v20.i20.6262

Lok AS, McMahon BJ. Chronic hepatitis B: update 2009. Hepatology 2009; 50: 661-2; http://dx.doi.org/10.1002/hep.23190

Carosi G, Rizzetto M, Alberti A, et al. Treatment of chronic hepatitis B: update of the recommendations from the 2007 Italian Workshop. Dig Liver Dis 2011; 43: 259-65; http://dx.doi.org/10.1016/j.dld.2010.10.014

Liaw YF, Kao JH, Piratvisuth T, et al. Asian-Pacific consensus statement on the management of chronic hepatitis B: a 2012 update. Hepatol Int 2012; 6: 531-61; http://dx.doi.org/10.1007/s12072-012-9386-z; http://dx.doi.org/10.1007/s12072-012-9365-4

Pérez-Cameo C, Pons M, Esteban R. New therapeutic perspectives in HBV: when to stop NAs. Liver Int 2014; 34: 146-53; http://dx.doi.org/10.1111/liv.12398

Ke W, Liu L, Zhang C, et al. Comparison of efficacy and safety of tenofovir and entecavir in chronic hepatitis B virus infection: a systematic review and meta-analysis. PLoS One 2014; 9:e98865; http://dx.doi.org/10.1371/journal.pone.0098865

Batirel A, Guclu E, Arslan F, et al. Comparable efficacy of tenofovir versus entecavir and predictors of response in treatment-naïve patients with chronic hepatitis B: a multicenter real-life study. Int J Infect Dis 2014; 28: 153-9; http://dx.doi.org/10.1016/j.ijid.2014.09.004

Huang M, Jie Y, Shi H, et al. Comparison of the efficacy of tenofovir disoproxil fumarate and entecavir for initial treatment of patient with chronic hepatitis B in China. Int J Clin Exp Med 2015; 8: 666-73

Woo G, Tomlinson G, Nishikawa Y, et al. Tenofovir and entecavir are the most effective antiviral agents for chronic hepatitis B: a systematic review and Bayesian meta-analyses. Gastroenterology 2010; 139: 1218-29; http://dx.doi.org/10.1053/j.gastro.2010.06.042

Wilder J, Patel K. The clinical utility of FibroScan® as a noninvasive diagnostic test for liver disease. Med Devices (Auckl) 2014; 7: 107-14; http://dx.doi.org/10.2147/MDER.S46943

Lok AS, Trinh H, Carosi G, et al. Efficacy of entecavir with or without tenofovir disoproxil fumarate for nucleos(t)ide-naïve patients with chronic hepatitis B. Gastroenterology 2012; 143: 619-628.e1; http://dx.doi.org/10.1053/j.gastro.2012.05.037

Downloads

Published

2015-12-22

Issue

Vol. 9 No. 4 (2015)

Section

Clinical management

License

Authors who publish with this journal agree to the following terms:
    1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution Non-Commercial 4.0 Licence that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
    2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal. The Publication Agreement can be downloaded here, and should be signed by the Authors and sent to the Publisher when the article has been accepted for publication in this journal.
    3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
    4. Authors are permitted to post their work online after publication (the article must link to publisher version, in html format)