Evulation of the efficacy of entecavir and tenofovir in chronic hepatitis B: Retrospective study

Hepatitis B infection is among the most common chronic infections all around the world. It?s suggested that 2 billion people worldwide are exposed to hepatitis B virus (HBV) and 400 milyon are infected with HBV. According to data from World Health Organisation, 5% of these people have chronic disease. Nearly 25% of chronic hepatitis B (CHB) patients evolve to cirrhosis and hepatocellular carcinoma (HCC). About 500.000-1.000.000 people per year worldwide pass away due to complications of hepatitis B virus. Recently interferons and nucleos(t)ide analogs are being used for the treatment of CHB and among nucleos(t)ide analogs, entecavir (ETV) and tenofovir (TNF) are the strongest oral antiviral agents due to their strong viral suppressive effects, high genetic barriers and low resistance rates. With this study, patients with CHB who haven?t taken any antiviral agents before (naive) or patients who have been followed up for liver cirrhosis due to CHB, started on entecavir or tenofovir were evaluated for virological, serological and biochemical effects of these agents and side effect of tenofovir ana entecavir were compared retrospectively. Total of 70 patients were enrolled to ETV group anf 65 were enrolled to TNF group who had taken at least 6 months of ETV or TNF for the treatment of CHB or who had been naive. HBV DNA, ALT, creatinine, HBs Ag, HBe Ag, phosforus and total creatinine kinase levels, side effects of agents and agent switches were evaluated at baseline and at months 3, 6, 12, 18, 24, 36, 48, 60 ve 72. there was no difference between groups in terms of age, sex, cirrhosis, HbeAg (+) status, baseline HBV DNA and ALT levels, baseline HAI and fibrosis values, where there was a statistically significant difference at mean followup period. Time to negative HBV DNA values were similar at entecavir and tenofovir groups during followup. ALT normalization was higher at entecavir group at months 3, 6 and 12. ALT normalization was similar between groups at months 18 and over. Time to negative HBe Ag and total side effect rates were similar. Creatinine levels were higher at months 6, 12, 18, 36 and 48 but creatinine increase at tenofovir group was within normal ranges. When MELD and Child scores calculated at baseline for the group of patients with cirrhosis were compared to those at the end of the followup, there were differences at both MELD and Child scores at tenofovir group, where there was a difference at Child score and no difference at MELD score at entecavir group