Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
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The Short Term Efficacy of Entecavir Therapy in Chronic Hepatitis B

만성 B형 간염 환자에서 엔테카비어의 단기 치료 효과

  • Kim, Hyun (Department of Internal Medicine, College of Medicine and Medical Research Institute, Chungbuk National University) ;
  • Chae, Hee-Bok (Department of Internal Medicine, College of Medicine and Medical Research Institute, Chungbuk National University) ;
  • Jeon, Won-Joong (Department of Internal Medicine, College of Medicine and Medical Research Institute, Chungbuk National University) ;
  • Park, Seon-Mee (Department of Internal Medicine, College of Medicine and Medical Research Institute, Chungbuk National University) ;
  • Youn, Sei-Jin (Department of Internal Medicine, College of Medicine and Medical Research Institute, Chungbuk National University) ;
  • Eun, Jong-Ryul (Department of Internal Medicine, Yeungnam University College of Medicine) ;
  • Lee, Heon-Ju (Department of Internal Medicine, Yeungnam University College of Medicine)
  • 김현 (충북대학교 의과대학 내과학교실) ;
  • 채희복 (충북대학교 의과대학 내과학교실) ;
  • 전원중 (충북대학교 의과대학 내과학교실) ;
  • 박선미 (충북대학교 의과대학 내과학교실) ;
  • 윤세진 (충북대학교 의과대학 내과학교실) ;
  • 은종렬 (영남대학교 의과대학 내과학교실) ;
  • 이헌주 (영남대학교 의과대학 내과학교실)
  • Published : 2008.06.30
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Abstract

Background/Aims : Entecavir is a synthetic nucleoside analogue, cyclopentyl guanine nucleoside, which has a potent antiviral effect and the least viral breakthrough in hepatitis B virus (HBV) replication. Entecavir has been available in Korea since 2007 but there are few reports on its effects. The aim of this study was to evaluate the virological response (VR) and biochemical response (BR) to entecavir in HBV patients at 3, 6 and 9 months after treatment with entecavir. Materials and Methods : Thirty-three chronic hepatitis B patients who took entecavir for at least 9 months were enrolled. We investigated VR and BR by retrospectively reviewing medical records. Patients who satisfied the following criteria were chosen: 1) initial alanine aminotransferase (ALT) levels = 1.5upper limit of normal (ULN) and 2) initial HBV DNA levels = $5\;log_{10}\;copies/ml$. We measured ALT levels every 3 months until month 9. HBV DNA was measured every 2 or 3 months by polymerase chain reaction (PCR) method. Results : Most patients taking entecavir showed good BR (ALT < 40 IU/L). The BR rates were 61%, 73% and 67% at months 3, 6 and 9, respectively. VR (HBV DNA < $5\;log_{10}\;copies/ml$ or 2 log lower than initial HBV DNA) rates were 82%, 91% and 91% at months 3, 6 and 9, respectively. Undetectable HBV DNA (HBV DNA < 4 log10 copies/ml) rates were 49%, 73% and 85% at months 3, 6 and 9, respectively. Two patients presented with virological breakthrough without adverse effects until month 9. Conclusions : Entecavir showed good BR and VR from month 3 and these effects continued through the 9-month observation period. This suggests that entecavir is also a good choice for the first line treatment of chronic hepatitis B (CHB). Further studies are needed to determine the long-term efficacy and drug resistance of entecavir in Korean CHB patients.

충북대학교 병원과 영남대학교 병원에서 만성 B형 간염으로 내원한 환자를 대상으로 9개월 동안 엔테카비어를 투약한 뒤 그 치료성적을 조사하여 본 결과 외국 연구의 성적과 유사하게 생화학적 반응에서 3개월째는 20명(61%), 6개월째는 24명 (73%), 9개월째는 22명(67%), 바이러스학적 반응에서 3개월째 바이러스학적 반응은 27명 (82%), 6개월째는 30명 (91%), 9개월째는 30명 (91%), 바이러스 비검출율에서 3개월째는 16명 (49%), 6개월째는 24명 (73%), 9개월째는 28명 (85%)로 우수한 치료성적을 보여주었다. 치료 9개월째 바이러스 돌파현상은 2명에서 관찰되었다. 결론적으로 엔테카비어는 만성 B형 간염 환자에서 이전의 다른 뉴클레오사이드 유도체보다 좋은 치료효과 및 낮은 내성 발현율을 보이고 있다.

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