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“Oral nucleos(t)ide analogs (NAs) are effective in suppressing hepatitis B virus (HBV) replication in treatment naïve chronic hepatitis B (CHB) patients. However, little is known about the treatment modification and adherence on such patients with prolonged NA treatment. In this multicenter observational study, a total of 600 NA-naïve Taiwanese CHB patients aged 16 years and older were enrolled. The 600 patients were retrospectively identified Adriamycin mw by their NA treatment history from August 2008 to July 2009; this cohort was prospectively followed up over 3

years. During the 3-year period, incidence of treatment modifications, reasons for modification, and rate of adherence

were evaluated. Among the 583 evaluable patients, the initial NA treatment included entecavir (ETV) in 468 patients, telbivudine (LdT) in 67, and lamivudine (LVD) in 48. During the 3-year treatment, 9.0% of ETV-treated patients, 38.8% of LdT-treated patients, and 54.2% of LVD-treated patients had treatment modification. The main reasons for treatment modification were fulfilling stopping criteria in the ETV group (40.5%) and virological breakthrough in both the LdT (61.5%) and LVD (46.2%) groups. The proportion RG-7388 clinical trial of patients with adherence rate (> 90%) at year 3 was 90.8% in the ETV group, 83.9% in the LdT group, and 83.9% in the LVD group. Treatment-naïve CHB patients with a 3-year ETV treatment in Taiwan have the lower likelihood of treatment modification and better rate of adherence compared with those with LdT or LVD treatment. Hepatitis B virus (HBV) infection is a global health problem, resulting in over one MCE million deaths per year.[1, 2] Patients with chronic HBV infection have an increased lifetime risk of developing cirrhosis, hepatic decompensation, and hepatocellular carcinoma (HCC).[2-4] It is estimated that 25–40% of HBV carriers who acquire the virus

early in life will eventually develop one or more of these debilitating complications.[2] Therefore, chronic hepatitis B (CHB) patients in the immunoactive phase who are at an increased risk of disease progression are candidates for antiviral treatment. All international guidelines indicate that the primary goal of CHB treatment is to permanently suppress HBV replication to an undetectable level as indicated by sensitive polymerase chain reaction assays. The ultimate goal is to halt or slow down disease progression to end-stage liver disease and to improve overall patient survival.[5-7] The approved agents for CHB treatment include immunomodulatory agents and oral nucleoside or nucleotide analogs (NAs), including lamivudine (LVD), adefovir (ADV), telbivudine (LdT), entecavir (ETV), and tenofovir disoproxil fumarate (TDF).