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Antivirals reduce death rates among hepatitis B patients:
Researchers compared death rates in 472 patients treated with
entecavir (Baraclude), 791 patients treated with lamivudine
(Epivir-HBV) plus adefovir (Hepsera), and 1,141 untreated HBV
patients for up to nine years to see if antivirals extended the lives of
people infected with HBV.
Over the course of the study, two patients
(0.7%) in the entecavir group died, eight (2.9%) died in the
lamivudine group, and 68 (24.9%) died in the control group. The
five-year survival rates were 99.1%, 97.6% and 92.2% in the
entecavir, lamivudine and control groups respectively.
Japanese researchers concluded that antivirals
(especially in cirrhotic patients) greatly reduce death rates in
hepatitis B patients.
Control ID 1736731. Long-term
nucleos(t)ide analog treatment reduces liver related mortality in
chronic hepatitis B patients. (Abstract #925)
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But antivirals did not lower liver cancer:
Researchers compared liver cancer rates in 132 patients treated
with antivirals (lamivudine or entecavir) for 48 weeks and 132
untreated patients. Both groups were similar in disease state, age
and gender.
As expected, those treated with antivirals
experienced declines in viral load and ALT levels, but liver
cancer rates in the antiviral-treated group were surprisingly
similar to the untreated control group. Liver cancer rates in the
treated group were 1.6% at year 2, 3.5% at year 3, 4.5% at year 5,
and 10.5% at year 10—similar to the control group's cancer rates
of 0.7%, 2.3%, 3.2%, and 7.4% during the same time period.
"Even with long-term (antiviral) treatment, the
incidence of liver cancer development was not reduced
significantly in HBV-infected patients," Japanese researchers
wrote. "Though long-term (antiviral) treatment can bring back
hepatic reserve effectively, careful observation with periodical
liver cancer screening is recommended."
Control ID 1734897. Nucleoside analogue
treatment can not reduce the incidence of hepatocellular carcinoma
in patients with chronic hepatitis B. (Abstract #965)
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Patients who develop surface antibodies can quit antivirals:
An Argentina study found that after two to three years of
entecavir treatment, 23 of 183 (14%) patients became
HBsAg-negative and 22 (13%) developed surface antibodies. More
than a year after stopping treatment, 18 patients who were still
followed continued to be surface antibody-positive.
Control ID 1725304. Relapse rates in chronic hepatitis B naïve patients after entecavir discontinuation in real life. (Abstract #910)