Comparative evaluation of three regimens for the treatment of chronic hepatitis B: Tenofovir, Entecavir and combination of Lamivudine and Adefovir

Jayakumar R and Singh S

: J Antivir Antiretrovir

Abstract :

C hronic hepatitis B is a disease of concern due to its life threatening complications like cirrhosis, and hepatocellular carcinoma (HCC) in 20-40% of patients. There are about 400 million people affected worldwide with HBV and over 300,000 die every year from HBV related diseases. Oral antivirals like lamivudine, adefovir, entecavir and tenofovir are commonly used to treat chronic hepatitis B. In this study, we tried to evaluate the comparative efficacy of these drugs alone and in combination. Chronic hepatitis B patients with HBV DNA more than 104Copies/mL irrespective of their HBeAg status (n=60) were enrolled in a prospective study. 21, 20 and 19 patients were treated with lamivudine (100mg/day) plus adefovir (10mg/day) combination entecavir monotherapy (0.5mg/day) and tenofovir monotherapy(300mg/day) respectively and followed up for 24 weeks with their virological, serological and biochemical markers measured at 12 and 24 weeks.After 24 weeks of treatment, there was no significant difference between the three groups in suppressing HBV DNA to undetectable levels. The median decrease in HBV DNA levels from baseline was better with tenofovir and entecavir monotherapies than lamivudine and adefovir combination which was statistically significant. There was no significant difference between the three groups in HBsAg and HBeAg seroconversion and normalization of biochemical parameters. Entecavir and tenofovir monotherapy were found to be more effective than lamivudine plus adefovir combination in reducing the HBV DNA levels. However, lamivudine plus adefovir combination was not too inferior especially when cost of treatment was taken into consideration

Biography :

Dr. Rajeswari Jayakumar is pursuing her MD in Laboratory medicine from All India Institute of Medical Sciences and she is working under the guidance of Dr. Sarman Singh on Hepatitis B