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Emmet B. Keeffe, MD, MACP Professor of Medicine Chief of Hepatology

Treatment of Chronic Hepatitis B: Highlights From the 41st Annual Meeting of the European Association for the Study of the Liver. Emmet B. Keeffe, MD, MACP Professor of Medicine Chief of Hepatology Co-Director, Liver Transplant Program Stanford University Medical Center.

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Emmet B. Keeffe, MD, MACP Professor of Medicine Chief of Hepatology

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  1. Treatment of Chronic Hepatitis B: Highlights From the 41st Annual Meeting of the European Association for the Study of the Liver Emmet B. Keeffe, MD, MACP Professor of Medicine Chief of Hepatology Co-Director, Liver Transplant Program Stanford University Medical Center Supported by an independent educational grant from

  2. Adefovir DipivoxilLong-term Therapy • Safety and efficacy over 4-5 years demonstrated[1,2] • 55% in 4-yr cohort and 71% in 5-yr cohort had >/= 1-point improvement in Ishak fibrosis score • Majority of patients normalized ALT and suppressed serum HBV DNA < 1000 copies/mL • Adverse events uncommon: 3% increased serum creatinine >/= 0.5 mg/dL • Adefovir resistance mutations: 0%, 3%, 11%, 18%, and 29% detected at 1, 2, 3, 4, and 5 years, respectively • Durability of HBeAg seroconversion = 91%[3] • Addition of adefovir to lamivudine before and after liver transplantation prevents graft reinfection[4] 1. Hadziyannis S, et al. J Hepatol.2006;44(Suppl 2):S283-S290. Abstract 494. 2. Borroto-Esoda K, et al. J Hepatol. 2006;44(Suppl 2):S179-S180.Abstract 483. 3. Chang TT, et al. J Hepatol. 2006;44(Suppl 2):S187.Abstract 503. 4. Schiff E, et al. J Hepatol. 2006;44(Suppl 2):S3.Abstract #2.

  3. Adefovir for HBeAg-Negative Chronic Hepatitis BReduction of Fibrosis Score >/= 1 Point Hadziyannis S, et al. J Hepatol. 2006;44(Suppl 2):S283-S290. Abstract 494.

  4. Entecavir96 Weeks of Therapy • Among patients with only a virologic response after 48 weeks of therapy treated for a second year, 96% treated with entecavir vs 64% treated with lamivudine had an HBV DNA level < 300 copies/mL[1] • Cumulative virologic response for all patients through Week 96 (HBV DNA < 300 copies/mL) was 94% for entecavir and 77% for lamivudine[1] • No evidence of entecavir resistance found in nucleoside-naive patients lacking lamivudine resistance at study entry and treated for 96 weeks[2] 1. Shouval D, et al. J Hepatol. 2006;44(Suppl 2):S21-S22.Abstract 45. 2. Colonno R, et al. J Hepatol. 2006;44(Suppl 2):S182. Abstract 490.

  5. Peginterferon alfa-2aEffect on Fibrosis Progression • Paired pretreatment and 24-week posttreatment biopsies analyzed • In HBeAg-positive patients, 33% had improved fibrosis and 33% had no change • In HBeAg-negative patients, 39% had improved fibrosis and 37% had no change • Rates of improved or stabilized fibrosis were significantly higher in patients with sustained serologic or virologic response at Week 72 Cooksley G, et al. J Hepatol. 2006;44(Suppl 2):S182-S183. Abstract 491.

  6. Telbivudine52 and 76 Weeks of Therapy *HBV DNA never < 5 log10 copies/mL; †P < .01 Ldt = telbivudine; Lam = lamivudine Gane E, et al. J Hepatol. 2006;44(Suppl 2):S183-S184. Abstract 493.

  7. Drugs for Chronic Hepatitis BLicensed and Under Development www.hivandhepatitis.com

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