BACKGROUND AND AIMS: Antiviral treatment responses for patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB) are well-defined by data from registration trials but may differ from patients seen in community settings where medical adherence is usually not as strictly monitored. The goal of this study was to examine the long-term outcomes of HBeAg-negative patients in a community clinical setting. METHODS: We performed a cohort study of 189 consecutive treatment-naïve patients with CHB who were treated with either entecavir (ETV) 0.5 mg daily (n=107) or adefovir dipivoxil (ADV) 10 mg daily (n=82) from 2002 to 2009 at two community clinics. RESULTS: All patients were Asians. Both ETV and ADV cohorts had similar median baseline ALT and HBV DNA levels. By year 4, a similar proportion of ETV and ADV patients who remained on monotherapy achieved complete viral suppression (91-96%); however, more patients in the ADV cohort required alternative therapy (27 vs. 5%). No patients in the ETV cohort developed resistance while 18% of the ADV cohort did. Cumulative nonadherence rates were 10 and 12% in ADV and ETV cohorts, respectively. CONCLUSIONS: Failure to monotherapy in a community clinical setting is due to both antiviral resistance and patient nonadherence. Medication nonadherence is likely to be a more important contributor to treatment failure than antiviral resistance, especially with new anti-HBV agents such as ETV and tenofovir.
BACKGROUND AND AIMS: Antiviral treatment responses for patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB) are well-defined by data from registration trials but may differ from patients seen in community settings where medical adherence is usually not as strictly monitored. The goal of this study was to examine the long-term outcomes of HBeAg-negative patients in a community clinical setting. METHODS: We performed a cohort study of 189 consecutive treatment-naïve patients with CHB who were treated with either entecavir (ETV) 0.5 mg daily (n=107) or adefovir dipivoxil (ADV) 10 mg daily (n=82) from 2002 to 2009 at two community clinics. RESULTS: All patients were Asians. Both ETV and ADV cohorts had similar median baseline ALT and HBV DNA levels. By year 4, a similar proportion of ETV and ADVpatients who remained on monotherapy achieved complete viral suppression (91-96%); however, more patients in the ADV cohort required alternative therapy (27 vs. 5%). No patients in the ETV cohort developed resistance while 18% of the ADV cohort did. Cumulative nonadherence rates were 10 and 12% in ADV and ETV cohorts, respectively. CONCLUSIONS: Failure to monotherapy in a community clinical setting is due to both antiviral resistance and patient nonadherence. Medication nonadherence is likely to be a more important contributor to treatment failure than antiviral resistance, especially with new anti-HBV agents such as ETV and tenofovir.
Authors: Nghi B Ha; Nghiem B Ha; Ruel T Garcia; Huy N Trinh; Andrew A Vu; Huy A Nguyen; Khanh K Nguyen; Brian S Levitt; Mindie H Nguyen Journal: Hepatology Date: 2009-09 Impact factor: 17.425
Authors: Emmet B Keeffe; Douglas T Dieterich; Steven-Huy B Han; Ira M Jacobson; Paul Martin; Eugene R Schiff; Hillel Tobias Journal: Clin Gastroenterol Hepatol Date: 2008-08-23 Impact factor: 11.382
Authors: Benjamin Yip; Kevin Chaung; Carrie R Wong; Huy N Trinh; Huy A Nguyen; Aijaz Ahmed; Ramsey Cheung; Mindie H Nguyen Journal: Dig Dis Sci Date: 2012-09-26 Impact factor: 3.199
Authors: L Lu; B Yip; H Trinh; C Q Pan; S-H B Han; C C Wong; J Li; S Chan; G Krishnan; C C Wong; M H Nguyen Journal: J Viral Hepat Date: 2014-11-24 Impact factor: 3.728
Authors: L H Nguyen; J Hoang; N H Nguyen; V D Vu; C Wang; H N Trinh; J Li; J Q Zhang; M H Nguyen Journal: Aliment Pharmacol Ther Date: 2016-07-01 Impact factor: 8.171
Authors: Nghiem B Ha; Nghi B Ha; Kevin T Chaung; Huy N Trinh; Huy A Nguyen; Khanh K Nguyen; Mindie H Nguyen Journal: Dig Dis Sci Date: 2013-11-19 Impact factor: 3.199