Brief Article
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World J Gastroenterol. Feb 7, 2013; 19(5): 721-726
Published online Feb 7, 2013. doi: 10.3748/wjg.v19.i5.721
Australian tertiary care outcomes of entecavir monotherapy in treatment naive patients with chronic hepatitis B
Farzan Fahrtash-Bahin, Viraj C Kariyawasam, Timothy Gray, Karen Byth, Jacob George, Mark W Douglas
Farzan Fahrtash-Bahin, Viraj C Kariyawasam, Jacob George, Mark W Douglas, Storr Liver Unit, Westmead Millennium Institute, University of Sydney at Westmead Hospital, 2145 Sydney, Australia
Karen Byth, Department of Biostatistics, School of Public Health, University of Sydney, 2145 Sydney, Australia
Timothy Gray, Mark W Douglas, Centre for Infectious Diseases and Microbiology and Sydney Emerging Infections and Biosecurity Institute, University of Sydney at Westmead Hospital, 2145 Sydney, Australia
Author contributions: Fahrtash-Bahin F collected data, analyzed data and wrote up manuscript; Kariyawasam VC collected data, analyzed data and wrote up manuscript; Gray T planned study, collected data and reviewed manuscript; Byth K analyzed data; George J planned study and reviewed manuscript; Douglas MW planned study, supervised data collection and analysis and revised manuscript.
Correspondence to: Mark W Douglas, MBBS, PhD, FRACP, Storr Liver Unit, Westmead Millennium Institute, University of Sydney at Westmead Hospital, PO Box 412, Westmead, 2145 Sydney, Australia. mark.douglas@sydney.edu.au
Telephone: +61-2-98457705 Fax: +61-2-96357582
Received: August 25, 2012
Revised: October 25, 2012
Accepted: November 14, 2012
Published online: February 7, 2013
Processing time: 164 Days and 15.9 Hours
Abstract

AIM: To evaluate the long-term treatment outcomes of entecavir monotherapy in treatment naive patients in an Australian tertiary care setting.

METHODS: A retrospective analysis of treatment naive patients receiving entecavir monotherapy through Westmead Hospital was performed. Patients were excluded if they had received previous treatment with another nucleoside or nucleotide analogue, were pregnant or less than 18 years old.

RESULTS: Out of 336 patients, 163 patients fulfilled the selection criteria. Range of follow up was 3-46 mo (mean 26 mo). 134 patients (82.2%) had pre-treatment biopsies, with 26 patients (16.0 %) demonstrating F3-4 fibrosis. In total, 153 patients (93.9%) achieved at least Partial Virological Suppression (PVS), with 134 patients (82.2%) achieving complete virological suppression. The cumulative CVS and PVS rates at 36 mo were 92.2% and 97.3%, respectively. 3 patients (1.8%) failed to achieve PVS, while 5 patients (3.0%) developed virological rebound. 128 patients (78.5%) maintained CVS throughout follow up. Predictors of CVS included lower baseline DNA level (P = 0.001), hepatitis B virus e antigen negative status (P = 0.001) and increasing age at treatment (log rank 0.001). No significant adverse effects were reported necessitating cessation of entecavir.

CONCLUSION: Entecavir monotherapy is efficacious and safe in an Australian tertiary care setting. Resistance and rebound rates are very low. This is similar to data from controlled and uncontrolled trials around the world.

Keywords: Chronic hepatitis B; Entecavir; Australia; Asia-Pacific; Monotherapy; Hepatitis B virus; Antivirals