Higher adherence with 3-year entecavir treatment than lamivudine or telbivudine in treatment-naive Taiwanese patients with chronic hepatitis B
Higher adherence with 3-year entecavir treatment than lamivudine or telbivudine in treatment-naive Taiwanese patients with chronic hepatitis B
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DOI：
10.1111/jgh.12416
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发表时间：
2014-01-01
影响因子：
4.1
通讯作者：
Chuang, Wan-Long
中科院分区：
文献类型：
--
作者：
Chien, Rong-Nan;Peng, Cheng-Yuan;Chuang, Wan-Long
背景与目的口服核糖核酸类似物(Nas)能有效抑制初治慢性乙型肝炎(CHB)患者的乙肝病毒复制。在这项多中心观察性研究中，共有600名年龄在16岁及以上的台湾地区幼稚的慢性乙肝患者入选。根据2008年8月至2009年7月的NA治疗病史，对600名患者进行了回顾性鉴定；对该队列进行了3年以上的前瞻性随访。结果在583例可评价的患者中，最初的NA治疗包括恩替卡韦(ETV)468例，替比夫定(LdT)67例，拉米夫定(LVD)48例。在3年的治疗中，9.0%的ETV治疗患者、38.8%的LdT治疗患者和54.2%的LVD治疗患者进行了治疗修改。修改治疗方案的主要原因是ETV组(40.5%)达到停药标准，LDT组(61.5%)和LVD组(46.2%)病毒学突破。第三年依从率(>；90%)的比例，电气组为90.8%，长气管组为83.9%，左气管组为83.9%。结论台湾治疗初治期CHB患者，电气管组的3年依从率较低，而依从率较低。
Background and AimsOral nucleos(t)ide analogs (NAs) are effective in suppressing hepatitis B virus (HBV) replication in treatment naive chronic hepatitis B (CHB) patients. However, little is known about the treatment modification and adherence on such patients with prolonged NA treatment.MethodsIn this multicenter observational study, a total of 600 NA-naive Taiwanese CHB patients aged 16 years and older were enrolled. The 600 patients were retrospectively identified by their NA treatment history from August 2008 to July 2009; this cohort was prospectively followed up over 3 years. During the 3-year period, incidence of treatment modifications, reasons for modification, and rate of adherence were evaluated.ResultsAmong the 583 evaluable patients, the initial NA treatment included entecavir (ETV) in 468 patients, telbivudine (LdT) in 67, and lamivudine (LVD) in 48. During the 3-year treatment, 9.0% of ETV-treated patients, 38.8% of LdT-treated patients, and 54.2% of LVD-treated patients had treatment modification. The main reasons for treatment modification were fulfilling stopping criteria in the ETV group (40.5%) and virological breakthrough in both the LdT (61.5%) and LVD (46.2%) groups. The proportion of patients with adherence rate (>90%) at year 3 was 90.8% in the ETV group, 83.9% in the LdT group, and 83.9% in the LVD group.ConclusionsTreatment-naive CHB patients with a 3-year ETV treatment in Taiwan have the lower likelihood of treatment modification and better rate of adherence compared with those with LdT or LVD treatment.