Efficacy and safety of long-term therapy with nucleos(t)ide analogues in chronic hepatitis B


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Abstract

Nucleos(t)ide analogues are first-line therapies for the treatment of chronic hepatitis B. However, the efficacy and safety of long-term treatment and the necessary duration of therapy remains the subject of discussion. Aim. To assess the efficacy and safety of long-term treatment with nucleos(t)ide analogues in patients with chronic hepatitis B. Materials and methods. We conducted an observational study in 101 chronic hepatitis B (HBeAg-negative and HBeAg-positive) patients treated (≥3 years) with entecavir, tenofovir or telbivudine. Results and discussion. Treatment with entecavir and tenofovir was associated with high rate of virologic and biochemical response (>95%) and HBeAg seroconversion (93% and 67%, respectively). Cumulative rate of virologic resistance was 0; 3.1% and 43.5% for tenofovir, entecavir and telbivudine, respectively. Long-term nucleos(t)ide analogues treatment resulted in a regress of liver fibrosis (from 8.92 to 7.18 kPa, р<0.0001) and reduction in the number of patients with advanced fibrosis (from 48.1% to 13.8%, р<0.0001). Entecavir and tenofovir were safe and well tolerated, while treatment with telbivudine was associated with development of myopathy in 13% of cases. Conclusion. Entecavir and tenofovir might be recommended for the treatment of chronic hepatitis B because of having potent antiviral effect, high genetic barriers against resistance and good safety.

About the authors

E K Ibragimov

I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

Author for correspondence.
Email: info@conmed.ru

аспирант, каф. внутренних, профессиональных болезней и ревматологии ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова»

Moscow, Russia

D T Abdurakhmanov

I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

Email: abdjamal@mail.ru

д.м.н., проф. каф. внутренних, профессиональных болезней и ревматологии ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова»

Moscow, Russia

T P Rozina

I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University); M.V. Lomonosov Moscow State University

Email: info@conmed.ru

к.м.н., доц. каф. внутренних, профессиональных болезней и ревматологии ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова», факультет фундаментальной медицины ФГБОУ ВО «МГУ им. М.В. Ломоносова»

Moscow, Russia

E N Nikulkina

I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

Email: info@conmed.ru

ассистент, каф. внутренних, профессиональных болезней и ревматологии ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова»

Moscow, Russia

E L Tanaschuk

I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

Email: info@conmed.ru

к.м.н., доц. каф. внутренних, профессиональных болезней и ревматологии ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова»

Moscow, Russia

A V Odintsov

I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

Email: info@conmed.ru

врач, клиника ревматологии, нефрологии и профпатологии ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова»

Moscow, Russia

S V Panevkina

I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

Email: info@conmed.ru

студентка ФГБОУ ВО «МГУ им. М.В. Ломоносова»

Moscow, Russia

S V Moiseev

I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University); M.V. Lomonosov Moscow State University

Email: info@conmed.ru

проф., зав. каф. внутренних, профессиональных болезней и ревматологии ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова», факультет фундаментальной медицины ФГБОУ ВО «МГУ им. М.В. Ломоносова»

Moscow, Russia

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