The effectivness of entecavir in chronic hepatitis B in patients resistant to lamivudine and adefovir

Background/aims: Entecavir, a nucleoside analog, is a new medication that is active against both lamivudine- and adefovir-resistant HBV. The aim of this study was to investigate the effectiveness of entecavir in patients with chronic hepatitis B resistant to lamivudine and/or adefovir therapy in patients from United Arab Emirates. Methods: In an observational prospective study, we followed 36 patients with chronic hepatitis B who received either lamivudine or adefovir monotherapy or combination therapy. Some of these patients were treated with peginterferon alfa 2a in the past. Twelve patients became resistant to these therapies with significantly elevated hepatitis B viral load, therefore lamivudine and adefovir therapy were stopped and entecavir 1mg daily was introduced. Results: Twelve out of 36 patients with chronic hepatitis B who received either lamivudine alone or in combination with adefovir relapsed during the treatment. Eleven out of 12 patients were HBeAg positive. One patient did not return for follow up after 3 months. The average follow up time with entecavir therapy was 7 months (3–14 months), and no side effects were observed during this period. Six out of 11 patients had more than 2 log decrease in HBV-DNA after 3 months. Further 4 patients showed response at 6 months, one patient had response at 1 year. One patient had a transient increase in HBV DNA level at 10 months of therapy, which was related to non-compliance, but the readministration of entecavir suppressed the viral load again. Conclusions: All patients with chronic hepatitis B resistant to lamivudine alone or in combination with adefovir, responded to entecavir with significant reduction in the hepatitis B viral load, and the response was evident at 3 months in half of the cases. Entecavir seems to be effective and safe medication in lamivudine and/or adefovir resistant cases.