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

Research output: Contribution to journalArticle

28 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

Fingerprint

Lamivudine
Hepatitis B virus
Fibrosis
End Stage Liver Disease
Mortality
DNA
Therapeutics
entecavir
Serum
Antiviral Agents
Survival Rate
Liver

Keywords

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

ASJC Scopus subject areas

  • Hepatology

Cite this

Comparison of the efficacies of lamivudine versus entecavir in patients with hepatitis B virus-related decompensated cirrhosis. / Hyun, Jong Jin; Seo, Yeon Seok; Yoon, Eileen; Kim, Tae Hyung; Kim, Dong Jin; Kang, Hyun Seok; Jung, Eun Suk; Kim, Jeong Han; An, Hyonggin; Kim, Ji Hoon; Yim, Hyung Joon; Yeon, Jong Eun; Lee, Hong Sik; Byun, Kwan Soo; Um, Soon-Ho; Kim, Chang Duck; Ryu, Ho Sang.

In: Liver International, Vol. 32, No. 4, 01.04.2012, p. 656-664.

Research output: Contribution to journalArticle

@article{ed2e36aebb8c448e91305055c188a085,
title = "Comparison of the efficacies of lamivudine versus entecavir in patients with hepatitis B virus-related decompensated cirrhosis",
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.",
keywords = "Cirrhosis, Decompensation, Entecavir, Hepatitis B virus, Lamivudine",
author = "Hyun, {Jong Jin} and Seo, {Yeon Seok} and Eileen Yoon and Kim, {Tae Hyung} and Kim, {Dong Jin} and Kang, {Hyun Seok} and Jung, {Eun Suk} and Kim, {Jeong Han} and Hyonggin An and Kim, {Ji Hoon} and Yim, {Hyung Joon} and Yeon, {Jong Eun} and Lee, {Hong Sik} and Byun, {Kwan Soo} and Soon-Ho Um and Kim, {Chang Duck} and Ryu, {Ho Sang}",
year = "2012",
month = "4",
day = "1",
doi = "10.1111/j.1478-3231.2011.02676.x",
language = "English",
volume = "32",
pages = "656--664",
journal = "Liver International",
issn = "1478-3223",
publisher = "Wiley-Blackwell",
number = "4",

}

TY - JOUR

T1 - Comparison of the efficacies of lamivudine versus entecavir in patients with hepatitis B virus-related decompensated cirrhosis

AU - Hyun, Jong Jin

AU - Seo, Yeon Seok

AU - Yoon, Eileen

AU - Kim, Tae Hyung

AU - Kim, Dong Jin

AU - Kang, Hyun Seok

AU - Jung, Eun Suk

AU - Kim, Jeong Han

AU - An, Hyonggin

AU - Kim, Ji Hoon

AU - Yim, Hyung Joon

AU - Yeon, Jong Eun

AU - Lee, Hong Sik

AU - Byun, Kwan Soo

AU - Um, Soon-Ho

AU - Kim, Chang Duck

AU - Ryu, Ho Sang

PY - 2012/4/1

Y1 - 2012/4/1

N2 - 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.

AB - 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.

KW - Cirrhosis

KW - Decompensation

KW - Entecavir

KW - Hepatitis B virus

KW - Lamivudine

UR - http://www.scopus.com/inward/record.url?scp=84858295076&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84858295076&partnerID=8YFLogxK

U2 - 10.1111/j.1478-3231.2011.02676.x

DO - 10.1111/j.1478-3231.2011.02676.x

M3 - Article

C2 - 22099071

AN - SCOPUS:84858295076

VL - 32

SP - 656

EP - 664

JO - Liver International

JF - Liver International

SN - 1478-3223

IS - 4

ER -