title: Clinical course of patients with insufficient viral suppression during entecavir therapy in genotype C chronic hepatitis B.
abstract: OBJECTIVE
  The clinical course of patients with insufficient virologic suppression diagnosed with chronic hepatitis B undergoing entecavir therapy is unclear.
  
  
  METHODS
  We retrospectively investigated the long-term clinical outcomes of entecavir treatment for more than 12 months in 355 nucleos(t)ide-naïve chronic hepatitis B patients, particularly those with primary non-response or partial virologic response.
  
  
  RESULTS
  The median duration of entecavir therapy was 40 months (range, 12-64 months). Virologic response was achieved in 315 patients (88.7%). One hundred forty-four (96.6%) of 149 HBeAg-negative patients achieved virologic response. Among 206 HBeAg-positive patients, 52 (25.2%) achieved HBeAg seroconversion. Virologic breakthrough was observed in 7 patients (2.0%). Of these 7 patients, 5 (1.4%) had genotypic resistance to entecavir. Primary non-response and partial virologic response were evident in 6 (1.7%) and 63 (17.7%) patients, respectively. During continuous prolonged entecavir therapy, virologic response of patients with primary non-response and partial virologic response was achieved in 6 (100%) and 28 (44.4%) patients, respectively.
  
  
  CONCLUSIONS
  The vast majority of chronic hepatitis B patients in this study achieved virologic response through prolonged entecavir therapy, with only 1.4% chance of viral resistance. Furthermore, all patients with primary non-response were able to achieve virologic response without adjustment of antiviral therapy.
authors: Department of Internal Medicine, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea.
authors: Sung-Jo
authors: SJ
authors: Bang
authors: Byung Gyu
authors: BG
authors: Kim
authors: Jung Woo
authors: JW
authors: Shin
authors: Hyeong Uk
authors: HU
authors: Ju
authors: Bo Ryung
authors: BR
authors: Park
authors: Min-Ho
authors: MH
authors: Kim
authors: Chang Jae
authors: CJ
authors: Kim
authors: Jae Ho
authors: JH
authors: Park
authors: In Du
authors: ID
authors: Jeong
authors: Seok Won
authors: SW
authors: Jung
authors: Neung Hwa
authors: NH
authors: Park
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D018450:Disease Progression; D024882:Drug Resistance, Viral / Q000235:genetics; D005260:Female; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006513:Hepatitis B e Antigens / Q000276:immunology; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D006513:Hepatitis B e Antigens; C413685:entecavir; D006147:Guanine