— Christine M. Kukka, Project Manager, HBV Advocate
If you are infected with the hepatitis B virus (HBV) and have a high viral load, which of the two leading antivirals do you choose? Do you opt for tenofovir (Viread) or entecavir (Baraclude)? A team of researchers from Stanford University recommend tenofovir hands down.
The researchers monitored 59 patients treated with tenofovir and 216 treated with entcavir and compared the two drugs’ effectiveness. Antivirals are pills taken daily that make it difficult for HBV to replicate. The patients were treated at four community liver clinics in northern California and monitored over a three-year period.
Among the 72 patients who tested negative for the hepatitis B “e” antigen (HBeAg) and had only moderately elevated viral loads, there was no significant difference in the performance of the two antivirals.
However, among HBeAg-positive patients with HBV DNA levels exceeding 1 million international units per milliliter (IU/mL), tenofovir worked far faster to suppress viral load.
After six months, 18% of tenofovir-treated patients achieved undetectable viral load compared to 11% in the entecavir group.
After 12 months, 51% of tenofovir patients had undetectable HBV DNA compared to 28% of entecavir patients.
And after 18 months, 72% of tenofovir-treated patients were HBV DNA-free, compared to 39% in the entecavir group.
“Tenofovir is significantly more effective than entecavir for achieving complete viral suppression in HBeAg-positive, (never before-treated) chronic hepatitis B patients with HBV DNA greater than 1 million IU/mL,” they wrote in the January issue of the journal of Alimentary Pharmacology and Therapeutics.
HBV Journal Review
Marcxh 1, 2014, Vol 11, no 3