Reuters Health Information (2008-11-05): Reversal of fibrosis and cirrhosis seen with long-term entecavir for chronic HBV
Reversal of fibrosis and cirrhosis seen with long-term entecavir for chronic HBV
Last Updated: 2008-11-05 17:13:33 -0400 (Reuters Health)
SAN FRANCISCO (Reuters Health) - Long-term treatment with the nucleoside analogue entecavir (Baraclude; Bristol-Myers Squibb) in patients with chronic hepatitis B virus (HBV) infection results in reversal of fibrosis and, in some milder cases, cirrhosis, investigators reported here at the annual meeting of the American Association of Liver Diseases.
Entecavir, approved in 2005 for the treatment of chronic HBV infection in adults, has selective anti-HBV activity. Results of a study with a median follow-up of 6 years, presented by Dr. Yun-Fan Liaw of Chang Gung Memorial Hospital in Taipei, Taiwan, showed that the drug not only reduces viral load but also improves liver histology.
The study involved 63 patients with chronic HBV infection, 47 of whom were HBeAg-positive. At baseline, the mean HBV DNA level was 9.2 log10 copies/mL, the mean Knodell necroinflammatory score was 7.9, and the mean Ishak fibrosis score was 2.4.
Biopsies were available from 57 patients after a median entecavir treatment time of 6 years.
Among the four patients with baseline cirrhosis (an Ishak fibrosis score of 5 or greater), there was an improvement in Ishak fibrosis score of 1 or greater, with a median change from baseline of -3.
"These data suggest that long-term treatment with entecavir has the potential to stop liver damage and may even improve liver fibrosis caused by chronic hepatitis B infection," Dr. Liaw told meeting attendees.
"The ability to provide effective long-term treatment with a potent antiviral with minimal resistance represents a positive step forward."
Japanese researchers reported similar findings in a study of 66 nucleoside-naive patients and 84 lamivudine-refractory patients with chronic HBV genotype C infection who were treated with entecavir for more than 96 weeks.
Dr. Y. Katano and colleagues at Nagoya University in Aichi reported that "there were significant improvements from baseline in Knodell necroinflammation and fibrosis for both na�ve and lamivudine-refractory patients" after a mean of 148 weeks of entecavir treatment.
"Notably, treatment beyond 48 weeks resulted in continued improvement in fibrosis scores in both na�ve and lamivudine-refractory patients." Dr. Katano said.