Real life adherence of chronic hepatitis B patients to entecavir treatment

Dig Liver Dis. 2015 Jul;47(7):577-83. doi: 10.1016/j.dld.2015.03.024. Epub 2015 Apr 8.

Abstract

Background: Real-life prospective data on adherence to nucleos(t)ide analogues in chronic hepatitis B patients are scarce.

Aims: We investigated adherence to entecavir in relation to virological response.

Methods: In this prospective study, we provided 100 consecutive chronic hepatitis B patients with a medication dispenser that monitored entecavir intake during 16 weeks therapy. Hepatitis B virus (HBV) DNA was measured at baseline and after 16 weeks. Beliefs about medicines were evaluated using a questionnaire.

Results: Adherence over 16 weeks averaged 85 ± 17%, with 70% of patients exhibiting good (i.e. ≥ 80%) adherence. Patients with poor (i.e. <80%) adherence were significantly younger (p=0.01), with more often indifferent attitudes towards entecavir (p=0.03) Viral breakthrough did not occur during the study. Adherence in patients with HBV DNA after 16 weeks > 20 IU/mL (n=18) and ≤ 20 IU/mL (n=81) averaged 83% and 91% respectively (p=0.19). In multivariate analysis, adherence was not a significant predictor of HBV DNA negativity (adjusted OR 1.02; p=0.34), after adjustment for duration of entecavir treatment (p<0.001) and HBe-status (p=0.001).

Conclusions: 70% of chronic hepatitis B patients exhibited good adherence to entecavir, with younger age and an indifferent attitude being risk factors for poor adherence. Poor adherence was not an independent predictor of virological response.

Keywords: Beliefs about medicine; Compliance; Hepatitis B virus; Real-time medication monitoring.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antiviral Agents / therapeutic use*
  • Drug Administration Schedule
  • Female
  • Guanine / analogs & derivatives*
  • Guanine / therapeutic use
  • Health Knowledge, Attitudes, Practice
  • Hepatitis B, Chronic / drug therapy*
  • Hepatitis B, Chronic / psychology
  • Humans
  • Male
  • Medication Adherence / psychology
  • Medication Adherence / statistics & numerical data*
  • Middle Aged
  • Prospective Studies
  • Surveys and Questionnaires
  • Treatment Outcome
  • Young Adult

Substances

  • Antiviral Agents
  • entecavir
  • Guanine