HEPATITIS

Entecavir for the Treatment of Chronic Hepatitis B Virus Infection

S. James Matthews, RPh, PharmD

Commentary by Harold L. Kirschenbaum, PharmD
Editor, New Drug Reviews
Arnold & Marie Schwartz College of Pharmacy and Health Sciences
Long Island University

More than 2 billion people worldwide are infected with the hepatitis B virus (HBV). Approximately 360 million of these persons have chronic hepatitis B infection, which carries the risk for cirrhosis of the liver, liver failure, and hepatocellular carcinoma. At least a half-million patients die each year from these complications.

In his article "Entecavir for the Treatment of Chronic Hepatitis B Virus Infection" (Clin Ther. 2006;28:184–203), Matthews reviews the pharmacologic profile and clinical utility of entecavir—a recently marketed oral therapy for chronic HBV infection. Entecavir is highly selective for HBV and inhibits all 3 steps of viral replication. Entecavir may be administered orally, has a low risk for drug–drug interactions, and does not require dose modification in patients with moderate to severe hepatic disease. Well-controlled clinical trials have demonstrated a benefit for entecavir compared with lamivudine in the management of patients with chronic HBV. Preliminary data are promising in patients coinfected with HIV or who require liver transplantation as a result of chronic HBV infection. The incidence of entecavir-induced adverse events has been found to be similar to those noted with lamivudine therapy and include headache, upper respiratory tract infection, nasopharyngitis, fatigue, dizziness, and gastrointestinal effects such as nausea. The recommended oral dosage in treatment-naive patients ≥16 years of age is 0.5 mg/d, while in patients in whom lamivudine treatment has failed or who have lamivudine-resistant mutants, the recommended dosage is 1.0 mg/d.

Disclaimer: Opinions expressed in articles are those of the authors and do not necessarily reflect those of Excerpta Medica, Inc., or the Editorial Board. Excerpta Medica, Inc., assumes no liability for any material published herein.