What is the role of entecavir (ETV) in the treatment of hepatitis B (HBV) (Hep B)?

Updated: Jun 08, 2021
  • Author: Nikolaos T Pyrsopoulos, MD, PhD, MBA, FACP, AGAF; Chief Editor: BS Anand, MD  more...
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Entecavir is a first-line agent in the treatment of hepatitis B. [19] This drug is a potent guanosine analogue inhibitor of the viral polymerase with 1.2% resistance in patients who have no history of previous treatment with nucleos(t)ide analogues and almost 56% resistance in 3TC-resistant patients during a 6-year treatment period. [75]

Advantages of therapy with this agent include potent antiviral activity and a low drug resistance rate, [19] although entecavir has less of a role than other agents in the treatment of 3TC-resistant hepatitis B.

A retrospective study demonstrated that HBV DNA responses at 12 months can potentially be used to evaluate entecavir therapy in nucleos(t)ide analogue ̶ naïve, HBV-infected patients. [76] Investigators reported 3 independent predictors for maintenance of viral suppression among patients on entecavir treatment at 3 years—lower baseline HBV DNA, undetectable HBV DNA at month 12, and negative HBeAg—as well as for the probability of HBeAg-seroconversion and the risk of drug resistance. [76]

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