title: First-line monotherapies of tenofovir and entecavir have comparable efficacies in hepatitis B treatment.
abstract: BACKGROUND
  Hepatitis B virus (HBV) infection is a health problem worldwide. Current treatment options for chronic hepatitis B (CHB) are nucleoside or nucleotide analogues and pegylated interferons. Tenofovir and entecavir are much more commonly used as they have better efficacy, tolerability, and high genetic barriers to resistance.
  
  
  OBJECTIVE
  The aim of this study was to assess the efficacies of tenofovir and entecavir in previously untreated CHB patients in a treatment cohort.
  
  
  METHODS
  We included CHB patients in a cohort including previously untreated HBeAg-positive and HBeAg-negative patients from 10 centers in Istanbul, Turkey. The patients were compared in terms of baseline characteristics, decrease in alanine transaminase (ALT), decrease in HBV-DNA to undetectable levels, HBeAg loss and anti-HBe development (among baseline HBeAg-positive patients), interventions to therapy because of lack of efficacy, side effects, severe side effects, and side effects that required change in treatment.
  
  
  RESULTS
  The study included 121 patients who were administered tenofovir and 130 patients who were administered entecavir. The majority of patients were men, with mild to moderate histology in both treatment groups. The mean duration of follow-up was 18 and 20 months for tenofovir and entecavir, respectively. Patients receiving both drugs showed comparable rates of HBeAg loss, rates of undetectable HBV-DNA levels, rates of ALT normalization, ALT decrease, and decrease in HBV-DNA. Both drugs were well tolerated.
  
  
  CONCLUSIONS
  This study shows that although the baseline characteristics did not match, tenofovir and entecavir sustained comparable virological efficacies. More patients discontinued entecavir during follow-up. Both drugs provided effective viral control, with few side effects.
authors.affiliation: aDepartment of Infectious Diseases, Cerrahpasa Medical School bDepartment of Infectious Diseases, Istanbul Medical School, Istanbul University cDepartment of Infectious Diseases, Bezmialem Vakif University dDepartment of Infectious Diseases, Medeniyet University eInfectious Diseases Unit, Sisli Etfal Research and Education Hospital fInfectious Diseases Unit, Haseki Research and Education Hospital gInfectious Diseases Unit, Buyukcekmece Research and Education Hospital hDepartment of Infectious Diseases, Bilim University iInfectious Diseases Unit, Basaksehir State Hospital jInfectious Diseases Unit, Haydarpasa Research and Education Hospital, Istanbul, Turkey.
authors.forename: Resat
authors.initials: R
authors.lastname: Ozaras
authors.forename: Bilgul
authors.initials: B
authors.lastname: Mete
authors.forename: Bahadir
authors.initials: B
authors.lastname: Ceylan
authors.forename: Nail
authors.initials: N
authors.lastname: Ozgunes
authors.forename: Alper
authors.initials: A
authors.lastname: Gunduz
authors.forename: Hayat
authors.initials: H
authors.lastname: Karaosmanoglu
authors.forename: Atahan
authors.initials: A
authors.lastname: Cagatay
authors.forename: Kadir
authors.initials: K
authors.lastname: Gokturk
authors.forename: Levent
authors.initials: L
authors.lastname: Erdem
authors.forename: Funda
authors.initials: F
authors.lastname: Kocak
authors.forename: Ebubekir
authors.initials: E
authors.lastname: Senates
authors.forename: Fehmi
authors.initials: F
authors.lastname: Tabak
mesh_terms: D000225:Adenine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects; D015331:Cohort Studies; D024882:Drug Resistance, Viral / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D006147:Guanine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D006515:Hepatitis B virus / Q000187:drug effects* / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000008:administration & dosage* / Q000009:adverse effects; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D000068698:Tenofovir; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D063065:Organophosphonates; D018894:Reverse Transcriptase Inhibitors; C413685:entecavir; D006147:Guanine; D000068698:Tenofovir; D000225:Adenine