Efficacy of switching to entecavir monotherapy in Japanese lamivudine-pretreated patients


Dr Fumitaka Suzuki, Department of Hepatology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470, Japan.
Email: fumitakas@toranomon.gr.jp


Background and Aims:  To assess the efficacy of switching Japanese chronic hepatitis B patients from lamivudine monotherapy to entecavir 0.5 mg/day.

Methods:  A retrospective analysis was conducted on 134 patients switched to entecavir between September 2006 and February 2008 for 6 months or more. Patients were divided into three groups based on viral load at entecavir switching point (baseline < 2.6, 2.6–5.0 and > 5.0 log10 copies/mL).

Results:  At baseline, detection of lamivudine-resistant virus was highest in patients with higher hepatitis B virus (HBV) DNA (76% vs 23% in ≥ 2.6 and < 2.6 log10 copies/mL, respectively), and in patients with longest previous exposure to lamivudine (52%, 28% and 24% for > 3 years, 1–3 years and < 1 year, respectively). Two years after entecavir switching, HBV DNA suppression to less than 2.6 log10 copies/mL was achieved in 100% (32/32), 92% (12/13) and 44% (4/9) of patients in the less than 2.6, 2.6–5.0 and more than 5.0 log10 copies/mL baseline groups, respectively. Alanine aminotransferase (ALT) normalization occurred in 76–96% and 90–100% of patients following 1 and 2 years of entecavir treatment, respectively. One patient (2.6–5.0 log10 copies/mL) with lamivudine-resistant mutants at baseline developed entecavir resistance at week 48 during follow up.

Conclusion:  Switching to entecavir 0.5 mg/day achieves or maintains undetectable HBV DNA levels and ALT normalization over 2 years, especially in patients with viral load less than 5.0 log10 copies/mL.