Real life adherence of chronic hepatitis B patients to entecavir treatment.
BACKGROUND
Real-life prospective data on adherence to nucleos(t)ide analogues in chronic hepatitis B patients are scarce.


OBJECTIVE
We investigated adherence to entecavir in relation to virological response.


METHODS
In this prospective study, we provided 100 consecutive chronic hepatitis B patients with a medication dispenser that monitored entecavir intake during 16 weeks therapy. Hepatitis B virus (HBV) DNA was measured at baseline and after 16 weeks. Beliefs about medicines were evaluated using a questionnaire.


RESULTS
Adherence over 16 weeks averaged 85 ± 17%, with 70% of patients exhibiting good (i.e. ≥ 80%) adherence. Patients with poor (i.e. <80%) adherence were significantly younger (p=0.01), with more often indifferent attitudes towards entecavir (p=0.03) Viral breakthrough did not occur during the study. Adherence in patients with HBV DNA after 16 weeks > 20 IU/mL (n=18) and ≤ 20 IU/mL (n=81) averaged 83% and 91% respectively (p=0.19). In multivariate analysis, adherence was not a significant predictor of HBV DNA negativity (adjusted OR 1.02; p=0.34), after adjustment for duration of entecavir treatment (p<0.001) and HBe-status (p=0.001).


CONCLUSIONS
70% of chronic hepatitis B patients exhibited good adherence to entecavir, with younger age and an indifferent attitude being risk factors for poor adherence. Poor adherence was not an independent predictor of virological response.
Department of Gastroenterology and Hepatology, University Medical Centrum Utrecht, Utrecht, The Netherlands.
Lotte G
LG
van Vlerken
Department of Gastroenterology and Hepatology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
Pauline
P
Arends
Department of Gastroenterology and Hepatology, University Medical Centrum Utrecht, Utrecht, The Netherlands; Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Utrecht, The Netherlands.
Faydra I
FI
Lieveld
Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Utrecht, The Netherlands.
Joop E
JE
Arends
Department of Gastroenterology and Hepatology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
Willem Pieter
WP
Brouwer
Department of Gastroenterology and Hepatology, University Medical Centrum Utrecht, Utrecht, The Netherlands.
Peter D
PD
Siersema
Department of Gastroenterology and Hepatology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands; Liver Clinic, Toronto Western and General Hospital, University Health Network, Toronto, Canada.
Harry L
HL
Janssen
Department of Gastroenterology and Hepatology, University Medical Centrum Utrecht, Utrecht, The Netherlands. Electronic address: K.J.vanErpecum@umcutrecht.nl.
Karel J
KJ
van Erpecum
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D007722:Health Knowledge, Attitudes, Practice; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult; D016903:Drug Monitoring
D000998:Antiviral Agents; C413685:entecavir; D006147:Guanine
Beliefs about medicine; Compliance; Hepatitis B virus; Real-time medication monitoring