Comparison of the efficacies of lamivudine versus entecavir in patients with hepatitis B virus-related decompensated cirrhosis

Jong Jin Hyun, Yeon Seok Seo, Eileen Yoon, Tae Hyung Kim, Dong Jin Kim, Hyun Seok Kang, Eun Suk Jung, Jeong Han Kim, Hyonggin An, Ji Hoon Kim, Hyung Joon Yim, Jong Eun Yeon, Hong Sik Lee, Kwan Soo Byun, Soon-Ho Um, Chang Duck Kim, Ho Sang Ryu

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29 Citations (Scopus)

Abstract

Background: Suppression of hepatitis B virus (HBV) DNA is more potent, and occurrence of resistant strain is rare with entecavir than lamivudine, but whether these merits result in a more favourable outcome in HBV-related decompensated cirrhosis patients is unclear. Aims: To compare virologic response, changes in liver function, clinical course and predictive factors for early mortality after treatment between patients treated with lamivudine and those with entecavir in HBV-related decompensated cirrhosis patients. Methods: HBV-related decompensated cirrhosis patients [Child-Turcotte-Pugh (CTP) score ≥ 7] treated with either lamivudine or entecavir were enrolled. Serum HBV DNA levels, CTP score and Model for End-stage Liver Disease (MELD) score were monitored every 3 months. Results: Eighty-six patients were enrolled; mean age was 54 ± 11 years, and 63 (73.3%) patients were men; 41 (47.7%) and 45 (52.3%) patients were assigned to the lamivudine group and entecavir group respectively. Although suppression of serum HBV DNA level was more potent in the entecavir group, CTP or MELD scores during the course of treatment did not differ between the two groups. Similarly, 6-month survival rates did not differ between the two groups (95.1 vs 93.2%, P = 0.684). Baseline CTP score and MELD score at 3 months of treatment were significantly associated with 6-month mortality. The 6- and 12-month mortality rates for patients with baseline CTP score ≥11 and MELD score ≥17.5 after 3 months of treatment were 42.9 and 61.9% respectively. Conclusions: Although HBV DNA suppression was more potent in the entecavir group than the lamivudine group, early mortality rates did not differ between the two groups. The baseline CTP score and MELD score 3 months after initiating antiviral treatment were significant predictors of early mortality.

Original languageEnglish
Pages (from-to)656-664
Number of pages9
JournalLiver International
Volume32
Issue number4
DOIs
Publication statusPublished - 2012 Apr 1

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Keywords

  • Cirrhosis
  • Decompensation
  • Entecavir
  • Hepatitis B virus
  • Lamivudine

ASJC Scopus subject areas

  • Hepatology

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