Entecavir for treatment of chronic hepatitis B: A clinical update for the treatment of patients with decompensated cirrhosis

The introduction of nucleos(t)ide analogues for the treatment of chronic hepatitis B virus (HBV) infection was transformative in reducing morbidity and mortality. Entecavir, a potent selective nucleoside analogue first approved in 2005 for treatment of chronic HBV, is associated with significant antiviral, biochemical, serologic, and histologic responses. Rapid reductions in HBV DNA levels, low risk of resistance development, and a favorable adverse event profile have contributed to its clinical usefulness. Re-cent developments in the use of entecavir have increased its utility in the management of difficult-to-treat patients with chronic HBV, including those patients with decompensated liver disease. Recent studies in this population have demonstrated that entecavir 1.0 mg/d given for up to 48 weeks had superior antiviral activity when compared with adefovir and was generally safe and well tolerated. Long-term outcomes of entecavir in difficult-to-treat populations are eagerly anticipated.