December 2015 Vol. 3 No.12

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Original Research Article

Virological response to treatment with entecavir in a cohort of chronic hepatitis B patients from Saudi Arabia Preliminary result

Hisham O. Akbar and Hind I. Fallatah^*

Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia

*Corresponding Author’s E-mail: Hindfallatah@hotmail.com

Accepted December 06, 2015

Abstract

Entecavir is a potent first-line Hepatitis B Virus (HBV) drug. This study was conducted to study the efficacy of entecavir in the treatment of Chronic Hepatitis B (CHB) patients from Saudi Arabia. A retrospective cohort study of CHB patients who were treated with entecavir at the Al Badriyah Tower Hepatology Clinic, Jeddah. All included patients were planned to complete at least 48 weeks of treatment and HBV-DNA testing every 6 weeks. Patients who had additional cause for liver disease were excluded. We obtained demographic data (age, sex and nationality), and the patients were categorized as treatment-naïve or treatment-experienced. Hepatitis B e-antigen (HBeAg) status, baseline aspartate aminotransferase (AST), and HBV-DNA levels were determined for all of the patients. Patients were considered for treatment according to various treatment guidelines. We also assess the stage of hepatic fibrosis using the fibroscan. Entecavir was administered at a dose of 1 mg daily for lamivudine-experienced patients; the remaining patients received 0.5 mg daily. All patients were monitored for treatment compliance and treatment side effects during the follow-up. A total of 146 patients were enrolled. They were predominantly male (77, 53.4%), and the majority were Saudi (144, 98.6%). The mean age was 38.75 years (22-67). The mean serum AST level was 49.68 U/L (SD 52.7).Most of the participants were negative for e-antigen CHB (142, 97.3%), and 45 (30.8%) were treatment-experienced. Entecavir dose: A total of 109 (74.7%) patients received 0.5 mg entecavir, and 37 (25.3%) patients received 1 mg entecavir. The mean baseline HBV-DNA level was 4666174.1 (SD=20248231.6, range=2,269-110,000,000). The HBV-DNA levels determined after 24 and 48 weeks of treatment were significantly lower compared to the baseline levels (24 weeks: 1033602.5, SD=4068826.1; 48 weeks: 1721916, SD 5258661, P=.019 and .015, respectively). Fifty-nine patients completed 48 weeks of treatment or longer. Two patients were non-responders at 48 weeks, and two patients experienced viral breakthrough after initial drop. The longest duration of follow-up with sustained negative viremia was 144 weeks. Our data showed that entecavir is highly effective and safe long term treatment for CHB among Saudi patients

Key words: CHB, Entecavir, Lamivudine, Saudi Arabia, Treatment experiences, Treatment naïve