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Prolonged use of tenofovir and entecavir in hepatitis B virus-related cirrhosis

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Abstract

Background and Aims

Limited data is available from India on outcome and efficacy of tenofovir and entecavir in hepatitis B virus (HBV)-related cirrhosis when used for prolonged time. We report the long-term efficacy and outcome of these antiviral drugs in patients with chronic HBV infection, with compensated or decompensated cirrhosis.

Methods

We retrospectively analyzed laboratory and clinical data of 400 HBV-related cirrhotic patients without access to liver transplantation, who were treated with tenofovir/entecavir therapy, from January 2007 to January 2014. Two hundred and ten (52.5 %) patients had at least one of the components of decompensation at baseline. Two hundred and twenty (55 %) and 180 (45 %) patients were initiated tenofovir and entecavir, respectively. Follow up period was 45 (12–68) months for tenofovir and 36 (11–60) months for entecavir.

Results

At the end of 1 year, levels of HBV DNA <20 IU/mL were achieved in 91.8 % and 88.8 % of patients, and alanine aminotransferase normalized in 54.5 % and 55.5 % of patients who received tenofovir and entecavir, respectively. At the last visit, Child-Turcotte-Pugh scores improved among 29.5 % of patients who received tenofovir, 25 % of those who received entecavir, and remained stable in 61.9 % and 65 % patients, respectively, in both groups. The 5-year cumulative rate of liver decompensation, hepatocellular carcinoma, and cirrhosis-related complications were 3.1 %, 1.9 %, and 2.1 % with an annual incidence of 0.8 %, 0.3 %, and 0.5 % per person-year, respectively.

Conclusion

Tenofovir and entecavir were effective and potent drugs for prolonged treatment of HBV cirrhosis and improved the overall clinical course.

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Conflict of interest

SKG, VKD, SKS, JG, MB, MT, NG, AR, and AKJ declare that they have no competing interests.

Ethics statement

The authors declare that the study was performed in a manner that conforms to the Helsinki Declaration of 1975, as revised in 2000 and 2008 concerning Human and Animal Rights, and the authors followed the policy concerning informed consent as shown on Springer.com.

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Authors and Affiliations

  1. Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221 005, India

    Sundeep Kumar Goyal, Vinod Kumar Dixit, Suneet Kumar Shukla, Jayant Ghosh, Manas Behera, Manish Tripathi, Neha Gupta, Arttrika Ranjan & Ashok Kumar Jain

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  1. Sundeep Kumar Goyal
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  2. Vinod Kumar Dixit
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  3. Suneet Kumar Shukla
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Correspondence to Sundeep Kumar Goyal.

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Goyal, S.K., Dixit, V.K., Shukla, S.K. et al. Prolonged use of tenofovir and entecavir in hepatitis B virus-related cirrhosis. Indian J Gastroenterol 34, 286–291 (2015). https://doi.org/10.1007/s12664-015-0576-1

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  • DOI: https://doi.org/10.1007/s12664-015-0576-1

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