title: Prolonged use of tenofovir and entecavir in hepatitis B virus-related cirrhosis.
abstract: OBJECTIVE
  Limited data is available from India on outcome and efficacy of tenofovir and entecavir in hepatitis B virus (HBV)-related cirrhosis when used for prolonged time. We report the long-term efficacy and outcome of these antiviral drugs in patients with chronic HBV infection, with compensated or decompensated cirrhosis.
  
  
  METHODS
  We retrospectively analyzed laboratory and clinical data of 400 HBV-related cirrhotic patients without access to liver transplantation, who were treated with tenofovir/entecavir therapy, from January 2007 to January 2014. Two hundred and ten (52.5 %) patients had at least one of the components of decompensation at baseline. Two hundred and twenty (55 %) and 180 (45 %) patients were initiated tenofovir and entecavir, respectively. Follow up period was 45 (12-68) months for tenofovir and 36 (11-60) months for entecavir.
  
  
  RESULTS
  At the end of 1 year, levels of HBV DNA <20 IU/mL were achieved in 91.8 % and 88.8 % of patients, and alanine aminotransferase normalized in 54.5 % and 55.5 % of patients who received tenofovir and entecavir, respectively. At the last visit, Child-Turcotte-Pugh scores improved among 29.5 % of patients who received tenofovir, 25 % of those who received entecavir, and remained stable in 61.9 % and 65 % patients, respectively, in both groups. The 5-year cumulative rate of liver decompensation, hepatocellular carcinoma, and cirrhosis-related complications were 3.1 %, 1.9 %, and 2.1 % with an annual incidence of 0.8 %, 0.3 %, and 0.5 % per person-year, respectively.
  
  
  CONCLUSIONS
  Tenofovir and entecavir were effective and potent drugs for prolonged treatment of HBV cirrhosis and improved the overall clinical course.
authors.affiliation: Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221 005, India. drsundeepgoyal@gmail.com.
authors.forename: Sundeep Kumar
authors.initials: SK
authors.lastname: Goyal
authors.affiliation: Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221 005, India.
authors.forename: Vinod Kumar
authors.initials: VK
authors.lastname: Dixit
authors.affiliation: Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221 005, India.
authors.forename: Suneet Kumar
authors.initials: SK
authors.lastname: Shukla
authors.affiliation: Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221 005, India.
authors.forename: Jayant
authors.initials: J
authors.lastname: Ghosh
authors.affiliation: Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221 005, India.
authors.forename: Manas
authors.initials: M
authors.lastname: Behera
authors.affiliation: Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221 005, India.
authors.forename: Manish
authors.initials: M
authors.lastname: Tripathi
authors.affiliation: Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221 005, India.
authors.forename: Neha
authors.initials: N
authors.lastname: Gupta
authors.affiliation: Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221 005, India.
authors.forename: Arttrika
authors.initials: A
authors.lastname: Ranjan
authors.affiliation: Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221 005, India.
authors.forename: Ashok Kumar
authors.initials: AK
authors.lastname: Jain
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006147:Guanine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019694:Hepatitis B, Chronic / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000209:etiology; D008113:Liver Neoplasms / Q000209:etiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D000068698:Tenofovir / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; C413685:entecavir; D006147:Guanine; D000068698:Tenofovir
keywords: Antiviral; Chronic hepatitis B; Hepatitis B Virus; Hepatocellular carcinoma; Liver Cirrhosis; Liver decompensation; Liver fibrosis; Ultrasonography